title: Diagnosis and treatment of lupus nephritis flares--an update.
abstract: Relapses or flares of systemic lupus erythematosus (SLE) are frequent and observed in 27-66% of patients. SLE flares are defined as an increase in disease activity, in general, requiring alternative treatment or intensification of therapy. A renal flare is indicated by an increase in proteinuria and/or serum creatinine concentration, abnormal urine sediment or a reduction in creatinine clearance rate as a result of active disease. The morbidity associated with renal flares is derived from both the kidney damage due to lupus nephritis and treatment-related toxic effects. Current induction treatment protocols achieve remission in the majority of patients with lupus nephritis; however, few studies focus on treatment interventions for renal flares in these patients. The available data, however, suggest that remission can be induced again in a substantial percentage of patients experiencing a lupus nephritis flare. Lupus nephritis flares are independently associated with an increased risk of deterioration in renal function; prevention of renal flares might, therefore, also decrease long-term morbidity and mortality. Appropriate immunosuppressive maintenance therapy might lead to a decrease in the occurrence of renal and extrarenal flares in patients with SLE, and monitoring for the early detection and treatment of renal flares could improve their outcomes.
authors.affiliation: Department of Medicine, Division of Nephrology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Ben
authors.initials: B
authors.lastname: Sprangers
authors.forename: Marianne
authors.initials: M
authors.lastname: Monahan
authors.forename: Gerald B
authors.initials: GB
authors.lastname: Appel
mesh_terms: D000208:Acute Disease; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015994:Incidence; D008181:Lupus Nephritis / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D009017:Morbidity; D011379:Prognosis; D012008:Recurrence
chemical_list: D007166:Immunosuppressive Agents