What approach do you use for monitoring renal response to LN therapy?
In which scenarios do you recommend repeat kidney biopsy in your patients with lupus nephritis?
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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...
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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...
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I agree with Dr. @Dr. First Last and @Dr. First Last. 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 (norma...
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