Pharmacotherapy of lupus nephritis: time for a consensus?
BACKGROUND
The optimal therapy for lupus nephritis has been the subject of considerable debate.


OBJECTIVE
To provide evidence- and expert-based recommendations.


METHODS
To review the literature and the European League Against Rheumatism recommendations.


RESULTS
Risk stratification based on histological, demographical, clinical and laboratory characteristics allows the identification of patients at high risk for loss of renal function, and thus more likely to benefit from more aggressive therapy. Achieving remission within the first months of treatment, irrespective of the agent used, correlates with good long-term renal outcomes; maintenance of remission can be achieved with less toxic therapies. Aggressive management of atherosclerosis risk factors and renoprotective therapy for those patients with chronic renal disease improve long-term survival and prognosis.
Perysinaki
Garyfallia
G
Rethymnon General Hospital, Division of Nephrology, Rethymnon, Greece.
Panagiotakis
Simeon
S
Bertsias
George
G
Boumpas
Dimitrios T
DT
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D065095:Calcineurin Inhibitors; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008181:Lupus Nephritis / Q000188:drug therapy / Q000276:immunology / Q000628:therapy; D010956:Plasmapheresis
D000305:Adrenal Cortex Hormones; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents