What approach do you use for monitoring renal response to LN therapy?
When do you utilize repeat biopsy vs simply trending urine studies and creatinine?
Answer from: at Academic Institution
Early in treatment, I will check a urinalysis, Urine protein: creatinine, and serum creatinine every 4-6 weeks to make sure that the patient is responding. After a few months, I will check every 2-3 months. I usually will recommend a repeat biopsy if 1) there is no response to treatment in six month...
At a minimum, I will monitor serum creatinine and urine chemistries every 6-12 weeks when starting therapy. However, we know that spot urine protein/creatinine ratios have poor concordance with lupus flares. Therefore, I have a low threshold to repeat a biopsy if the proteinuria/hematuria is not app...
I agree with Dr. @Bonnie Bermas and @Megan M. Lockwood. However, I'll add that I do offer a bx to patients after 3-5 years in remission (the recent International Lupus Conference suggested 4 years as the "sweet spot") before tapering mycophenolate mofetil (MMF).Reason: Clinical renal remissions (nor...
Comments
at Duke University Medical Center Sometimes we have had challenges getting repeat re...
at Uniformed Services University of the Health Sciences (USUHS) Dr. @Mithu Maheswaranathan, no, because I order my...
at Duke University Medical Center That's great to hear! They will usually do it for ...