Dutch guidelines for diagnosis and therapy of proliferative lupus nephritis.
Proliferative lupus nephritis is a strong predictor of morbidity and mortality in patients with systemic lupus erythematosus. Despite improvements in the management of lupus nephritis, a significant number of the patients do not respond to immunosuppressive therapy and progress to end-stage renal failure. In order to optimise the diagnostic strategy and treatment of patients with proliferative lupus nephritis, guidelines are needed. In this review, the Dutch Working Party on Systemic Lupus Erythematosus provides recommendations regarding four important areas in patients with proliferative lupus nephritis: I) indications for a first renal biopsy, II ) definitions of treatment response, III ) selection of treatment options, and IV) indications for a repeat biopsy.
Department of Nephrology, VU University Medical Centre, Amsterdam, the Netherlands. Tellinge.A@zaansmc.nl
A
A
van Tellingen
A E
AE
Voskuyl
M G
MG
Vervloet
M
M
Bijl
R G L
RG
de Sévaux
S P
SP
Berger
R H W M
RH
Derksen
J H M
JH
Berden
D018501:Antirheumatic Agents / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D001706:Biopsy; D003520:Cyclophosphamide / Q000627:therapeutic use; D018450:Disease Progression; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000473:pathology; D008181:Lupus Nephritis / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D009426:Netherlands; D017410:Practice Guidelines as Topic; D011379:Prognosis; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D009173:Mycophenolic Acid; D001379:Azathioprine