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REVIEW article

Front. Nephrol.
Sec. Glomerular disease
Volume 4 - 2024 | doi: 10.3389/fneph.2024.1417026
This article is part of the Research Topic Women in Glomerular Disease View all 3 articles

Evidence based treatment for lupus nephritis: Present perspectives and challenges

Provisionally accepted
Efstathios Xagas Efstathios Xagas 1*Konstantinos Drouzas Konstantinos Drouzas 1George Liapis George Liapis 2Sophia Lionaki Sophia Lionaki 1
  • 1 2nd Department of Internal Medicine, University General Hospital Attikon, Athens, Greece
  • 2 National and Kapodistrian University of Athens, Independent researcher, Athens, Greece

The final, formatted version of the article will be published soon.

    Systemic lupus erythematosus (SLE) is a complex autoimmune disease known for its high heterogeneity among individuals, which affects various organs including the kidneys. Lupus nephritis (LN) is a frequent and life-threatening manifestation of the disease, with up to 50% of patients developing kidney involvement. Classification of renal involvement in lupus is based on specific histopathological findings, guiding therapeutical decisions. Immunosuppressive therapy, particularly glucocorticoids combined with cyclophosphamide or mycophenolate mofetil, has been the mainstay of treatment for many years, while rates of complete remission have not changed dramatically. Despite advancements in therapy, in an important proportion of patients LN leads to end-stage kidney disease (ESKD). Emerging therapies including belimumab, voclosporin, and obinutuzumab offer promising results in improving renal outcomes, especially in refractory or relapsing disease. Maintenance therapy is crucial to prevent disease flares and preserve renal function. Supportive measures including lifestyle modifications and non-immunosuppressive pharmacological interventions are nowadays also essential in managing LN. This review emphasizes recent advances of therapy and challenges regarding treatment optimization with strategies to improve long-term outcomes.

    Keywords: Lupus Nephritis, therapy, Outcome, histopathology, Management

    Received: 13 Apr 2024; Accepted: 22 Jul 2024.

    Copyright: © 2024 Xagas, Drouzas, Liapis and Lionaki. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Efstathios Xagas, 2nd Department of Internal Medicine, University General Hospital Attikon, Athens, Greece

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.