What is your approach to nephrology referral for patients with lupus nephritis?

The answer to this question "depends" on many factors.

I had the luxury of learning under some lupus nephritis greats in the 1990s (John "Jack" Klippel, H Austin, and J Balow... the high-dose NIH CYC regimen guys). Therefore, I am fortunate to feel confident in my abilities to care for LN better than...

As a nephrologist, I think any patient with lupus and urinary abnormalities should be seen by a nephrologist. I have seen cut-offs on proteinuria for a biopsy, but that decision has to be weighed with everything else, hematuria, creatinine, serology, symptoms, etc. And the decision may be made by bo...

I agree with Dr. @Dr. First Last that it depends on local practice expertise factors. For example, I too, although with less exposure, learned management of LN from Drs. Austin, Balow, Klippel, and Steinberg during an elective at the NIH during my senior year of medical school in the fall of 1979 ob...

Interdisciplinary collaborative care is crucial in the treatment of SLE, particularly in lupus nephritis. I work closely with my nephrology colleagues in the management of LN. We know that outcomes are better when patients with LN are managed by both a rheumatologist and a nephrologist.