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Lupus Nephritis

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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Samir V Parikh, Brad H Rovin
The introduction of corticosteroids and later, cyclophosphamide dramatically improved survival in patients with proliferative lupus nephritis, and combined administration of these agents became the standard-of-care treatment for this disease. However, treatment failures were still common and the rate of progression to ESRD remained unacceptably high. Additionally, treatment was associated with significant morbidity. Therefore, as patient survival improved, the goals for advancing lupus nephritis treatment shifted to identifying therapies that could improve long-term renal outcomes and minimize treatment-related toxicity...
June 9, 2016: Journal of the American Society of Nephrology: JASN
Monique Bethel, Frances M Yang, Shuang Li, N Stanley Nahman, Alyce M Oliver, Wambui Machua, Laura D Carbone
OBJECTIVES: To determine dosing patterns and examine predictors of filled hydroxychloroquine (HCQ) prescriptions in patients with systemic lupus erythematosus (SLE) with end-stage renal disease (ESRD). METHODS: This was a retrospective cohort study of patients with SLE in the US Renal Data System (USRDS) database in fiscal year 2011. All patients were Medicare Part D beneficiaries. Patients with a diagnosis of SLE were identified by the International Classification of Diseases, 9th revision code 710...
April 2016: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Suzanne Wilhelmus, Ingeborg M Bajema, George K Bertsias, Dimitrios T Boumpas, Caroline Gordon, Liz Lightstone, Vladimir Tesar, David R Jayne
In the past years, many (randomized) trials have been performed comparing the treatment strategies for lupus nephritis. In 2012, these data were incorporated in six different guidelines for treating lupus nephritis. These guidelines are European, American and internationally based, with one separate guideline for children. They offer information on different aspects of the management of lupus nephritis including induction and maintenance treatment of the different histological classes, adjunctive treatment, monitoring of the patient, definitions of response and relapse, indications for (repeat) renal biopsy, and additional challenges such as the presence of vascular complications, the pregnant SLE patient, treatment in children and adolescents and considerations about end-stage renal disease and transplantation...
June 2016: Nephrology, Dialysis, Transplantation
Zhihong Liu, Haitao Zhang, Zhangsuo Liu, Changying Xing, Ping Fu, Zhaohui Ni, Jianghua Chen, Hongli Lin, Fuyou Liu, Yongcheng He, Yani He, Lining Miao, Nan Chen, Ying Li, Yong Gu, Wei Shi, Weixin Hu, Zhengzhao Liu, Hao Bao, Caihong Zeng, Minlin Zhou
BACKGROUND: Treatment of lupus nephritis (LN) remains challenging. OBJECTIVE: To assess the efficacy and safety of a multitarget therapy consisting of tacrolimus, mycophenolate mofetil, and steroid compared with intravenous cyclophosphamide and steroid as induction therapy for LN. DESIGN: 24-week randomized, open-label, multicenter study. ( NCT00876616). SETTING: 26 renal centers in China. PATIENTS: Adults (aged 18 to 65 years) with biopsy-proven LN...
January 6, 2015: Annals of Internal Medicine
Yujuan Liu, Hans-Joachim Anders
BACKGROUND/AIMS: Lupus nephritis is an organ manifestation of systemic autoimmunity. Current treatment algorithms are still based on unselective immunosuppressive drugs. There is hope that highly selective biological drugs could be as or even more effective but less toxic. A profound understanding of the pathogenesis of lupus nephritis is necessary to identify the optimal molecular targets. METHODS: PubMed and were searched using 'lupus nephritis' as the key word...
2014: Nephron. Clinical Practice
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