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Nephrology

Lupus nephritis   

Questions discussed in this category

Would you proceed with renal transplant in a patient with lupus nephritis who has progressed to ESRD and is clinically stable, but has persistently elevated dsDNA and low complements despite appropriate doses of hydroxychloroquine and mycophenolate?
2 Answers available
What factors do you consider when advising a patient with lupus nephritis on the safety of becoming pregnant?
3 Answers available
How would you approach a patient with class III and V lupus nephritis, already on HCQ, MMF, voclosporin and losartan, but has continued proteinuria not yet attaining complete renal response?
Would you consider a dose of rituximab? 
4 Answers available
What do you feel are the potential barriers to widespread use of obinutuzumab in proliferative lupus nephritis?
What key factors will you consider when selecting patients for this therapy?This question is part of a collaboration with RheumMadness and i...
2 Answers available
What is your treatment approach when managing patients with relapsing lupus nephritis who previously achieved remission with mycophenolate and steroids?
6 Answers available
In the treatment of lupus nephritis, which patients may benefit from the use of rituximab or other B-cell depleting agents during induction?
This question is part of a collaboration with RheumMadness and is specifically in reference to: Obinutuzumab in Lupus Nephritis
2 Answers available
Do you ever combine voclosporin and belimumab in the treatment of lupus nephritis?
Do you use them sequentially or together?
3 Answers available
How do you approach the management of patients with suspected membranous lupus nephritis who are found to have positive PLA2R antibodies?
1 Answer available
How would you manage a patient with CKD4 due to lupus nephritis of unknown class who develops AKI requiring hemodialysis and nephrotic range proteinuria and is found to have atrophic kidneys on imaging?
3 Answers available
Should HCQ be continued in an asymptomatic SLE patient who has received renal transplant?
If a patient has received a kidney transplant for SLE-LN and is stable and doing well. Managed by their transplant team and on chronic immunosuppressi...
2 Answers available
How do you manage a pregnant patient with lupus who develops renal disease during pregnancy that is not due to pre-eclampsia?
2 Answers available
What is your threshold to repeat a kidney biopsy in a patient with a history of lupus nephritis who is on maintenance therapy and develops subtle changes in urinary protein excretion or microscopic hematuria?
3 Answers available
What drives you to choose voclospsorin over tacrolimus given the substantially higher cost?
2 Answers available
Do you hospitalize patients with newly diagnosed lupus nephritis and nephrotic syndrome if you are able to provide pulse steroids outpatient and follow them closely?
 When do you decide to hospitalize?
1 Answer available
Do you require lupus patients with ESKD or advanced CKD to be on minimal immunosuppression around the time of kidney transplantation?
1 Answer available
How would you approach the management of a new SLE patient presenting with lupus podocytopathy with FSGS and severe proteinuria (Pr/Cr 18) without immune complex deposition?
2 Answers available
How do you determine duration of therapy for patients who have responded well to voclosporin therapy?
How do you monitor response and what do you consider a satisfactory response? Do you aim for a certain threshold of proteinuria?
3 Answers available
How do you approach discussing the pill burden of voclosporin with patients who already have to take a regimen such as MMF+HCQ+ACEi and possibly more?
2 Answers available
Would you feel comfortable adding benlysta to patient already taking both mycophenolate and tacrolimus (and hydroxychloroquine) who still has some evidence of active lupus nephritis?
3 Answers available
Would you treat a patient aggressively for lupus nephritis if they have persistent proteinuria over 1 gram but cannot get a timely kidney biopsy?
3 Answers available
Is there a role for eculizumab in the management of refractory lupus nephritis?
3 Answers available
Do you routinely advise patients waiting for a kidney transplant to seek referrals at multiple institutions to decrease waiting time?
1 Answer available
What do you use for treatment induction in pure class V lupus nephritis with nephrotic-range proteinuria when MMF is contraindicated?
2 Answers available
In which clinical scenarios is relying on the urine protein-to-creatinine ratio as a measure of proteinuria unreliable, and interpretations should be made looking at urine protein and urine creatinine separately?
1 Answer available
What is your approach to using NIH activity and chronicity indices from renal biopsy in tailoring immunosuppression to a patient with new lupus nephritis?
3 Answers available
How do you approach the management of immunosuppression in patients with lupus nephritis that go on to dialysis?
3 Answers available
How do steroids and/or DMARDs affect biopsy results if a renal biopsy for suspected lupus nephritis is delayed?
1 Answer available


Papers discussed in this category

Arthritis and rheumatism, 2012-04
Efficacy and safety of rituximab in patients with active proliferative lupus nephritis: the Lupus Nephritis Assessment with Rituximab study.
Ann Rheum Dis, 2013 Jun 05
Prospective observational single-centre cohort study to evaluate the effectiveness of treating lupus nephritis with rituximab and mycophenolate mofetil but no oral steroids.
Annals of the rheumatic diseases, 2021 Oct 06
B-cell depletion with obinutuzumab for the treatment of proliferative lupus nephritis: a randomised, double-blind, placebo-controlled trial.
The New England journal of medicine, 2025 Feb 07
Efficacy and Safety of Obinutuzumab in Active Lupus Nephritis.
Kidney international, 2009-12
A prospective study of protein excretion using short-interval timed urine collections in patients with lupus nephritis.
Clinical journal of the American Society of Nephrology : CJASN, 2010-07
Comparison of urinary albumin-creatinine ratio and albumin excretion rate in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study.
Journal of the American Society of Nephrology : JASN, 2010-08
Comparison of different measures of urinary protein excretion for prediction of renal events.
Am J Kidney Dis, 2016 Sep 16
Timed Urine Collections for Albumin and Protein: "The King Is Dead, Long Live the King!".
J Rheumatol, 2004 Aug
Urine protein-to-creatinine ratio is a reliable measure of proteinuria in lupus nephritis.
The American journal of medicine, 1983-09
Prognostic factors in lupus nephritis. Contribution of renal histologic data.
Arthritis care & research, 2011-06
Predicting outcomes of lupus nephritis with tubulointerstitial inflammation and scarring.
Kidney international, 2018-04
Revision of the International Society of Nephrology/Renal Pathology Society classification for lupus nephritis: clarification of definitions, and modified National Institutes of Health activity and chronicity indices.
Kidney Int, 2010 Feb 24
Tubulointerstitial lesions of patients with lupus nephritis classified by the 2003 International Society of Nephrology and Renal Pathology Society system.
Rheumatology international, 2017 Mar 03
Expanding the therapeutic options for renal involvement in lupus: eculizumab, available evidence.
Rheumatology (Oxford, England), 2015 Aug 27
Eculizumab as rescue therapy in severe resistant lupus nephritis.
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2017 Mar-Apr
Biopsy of small kidneys: A safe and a useful guide to potentially treatable kidney disease.
Clinical journal of the American Society of Nephrology : CJASN, 2017 May 04
Clinical and Histopathologic Characteristics Associated with Renal Outcomes in Lupus Nephritis.
Arthritis and rheumatism, 2011-12
A phase III, randomized, placebo-controlled study of belimumab, a monoclonal antibody that inhibits B lymphocyte stimulator, in patients with systemic lupus erythematosus.
N Engl J Med,
Two-Year, Randomized, Controlled Trial of Belimumab in Lupus Nephritis.
Lupus,
Hydroxychloroquine use predicts complete renal remission within 12 months among patients treated with mycophenolate mofetil therapy for membranous lupus nephritis.
Arthritis Rheumatol, 2017 Apr 07
Efficacy and Safety of Subcutaneous Belimumab in Systemic Lupus Erythematosus: A Fifty-Two-Week Randomized, Double-Blind, Placebo-Controlled Study.
Lancet (London, England), 2011 Feb 04
Efficacy and safety of belimumab in patients with active systemic lupus erythematosus: a randomised, placebo-controlled, phase 3 trial.
Lupus Sci Med, 2018
Serum albumin at 1 year predicts long-term renal outcome in lupus nephritis.
Cancer, 2006-09-15
Treatment of pregnant breast cancer patients and outcomes of children exposed to chemotherapy in utero.
Journal of the National Medical Association, 1979 Feb
Administration of cyclophosphamide during late pregnancy and early lactation: a case report.
Annals of the rheumatic diseases, 2023 Oct 12
EULAR recommendations for the management of systemic lupus erythematosus: 2023 update.
Kidney international, 2024 Jan
KDIGO 2024 Clinical Practice Guideline for the management of LUPUS NEPHRITIS.
Lupus, 2023 Sep 27
Repeat kidney biopsy findings of lupus nephritis patients in clinical remission treated with Mycophenolate associated with Belimumab or Mycophenolate plus standard of care therapy. A "post-hoc" analysis of participants in the BLISS-LN and open label extension study belonging to a single center.
Arthritis & rheumatology (Hoboken, N.J.), 2023 Jul 19
Safety and Efficacy of Long-Term Voclosporin Treatment for Lupus Nephritis in the Phase 3 AURORA 2 Clinical Trial.
Arthritis Rheumatol, 2020 Aug 4
CALIBRATE: A Phase 2 Randomized Trial of Rituximab Plus Cyclophosphamide Followed by Belimumab for the Treatment of Lupus Nephritis.
Cureus, 2023 May 10
Treatment Using Both Voclosporin and Belimumab in Four Patients With Lupus Nephritis.
BMJ open, 2019 Dec 16
Belimumab after B cell depletion therapy in patients with systemic lupus erythematosus (BEAT Lupus) protocol: a prospective multicentre, double-blind, randomised, placebo-controlled, 52-week phase II clinical trial.
Annals of the rheumatic diseases, 2024 Oct 21
Efficacy and safety of sequential therapy with subcutaneous belimumab and one cycle of rituximab in patients with systemic lupus erythematosus: the phase 3, randomised, placebo-controlled BLISS-BELIEVE study.
Journal of the American Society of Nephrology : JASN, 2009-05
Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis.
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2011-12
The PROMISE study: a phase 2b multicenter study of voclosporin (ISA247) versus tacrolimus in de novo kidney transplantation.
Kidney international, 2019-01
A randomized, controlled double-blind study comparing the efficacy and safety of dose-ranging voclosporin with placebo in achieving remission in patients with active lupus nephritis.
Lancet, 2021 May 07
Efficacy and safety of voclosporin versus placebo for lupus nephritis (AURORA 1): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial.
Annals of internal medicine, 2015 Jan 06
Multitarget therapy for induction treatment of lupus nephritis: a randomized trial.
Arthritis and rheumatism, 2013-07
Vitamin D in systemic lupus erythematosus: modest association with disease activity and the urine protein-to-creatinine ratio.
Arthritis care & research, 2023 Nov 28
Reference Range of Hydroxychloroquine Blood Levels That Can Reduce Odds of Active Lupus and Prevent Flares.
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2023 Mar 31
The influence of repeated flares in response to therapy and prognosis in lupus nephritis.
Clinical transplantation, 2020 Nov 22
Hydroxychloroquine and maintenance immunosuppression use in kidney transplant recipients: Analysis of linked US registry and claims data.
Transplantation, 2003-03-15
Recurrent lupus nephritis in renal transplant recipients revisited: it is not rare.
Journal of the American Society of Nephrology : JASN, 2010-07
Recurrence of lupus nephritis after kidney transplantation.
Seminars in arthritis and rheumatism, 2016 Sep 21
The utility of lupus serology in predicting outcomes of renal transplantation in lupus patients: Systematic literature review and analysis of the Toronto lupus cohort.

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