The answer to this question "depends" like most of these questions. 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 feel very fortunate to feel very confident in my abilities...

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. @Thomas 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 observing ...