Kidney involvement in systemic lupus erythematosus: From the patient assessment to a tailored treatment.

Autor: Mejia-Vilet JM; Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico., Turner-Stokes T; Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, Hammersmith Campus, London, United Kingdom., Houssiau F; Pôle de Pathologies Rhumatismales Inflammatoires et Systémiques, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain and Service de Rhumatologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium., Rovin BH; Division of Nephrology, The Ohio State University, Columbus, OH, United States. Electronic address: Rovin.1@osu.edu.
Jazyk: angličtina
Zdroj: Best practice & research. Clinical rheumatology [Best Pract Res Clin Rheumatol] 2023 Dec; Vol. 37 (4), pp. 101925. Date of Electronic Publication: 2023 Dec 26.
DOI: 10.1016/j.berh.2023.101925
Abstrakt: In the last few years, several studies have provided new evidence for the diagnosis, management, and follow-up of patients with lupus nephritis. Evidence showing dissociation between clinical and histological findings has prompted reevaluation of the role of the kidney biopsy as a tool for diagnosis and follow-up. In therapeutics, four immunosuppressive schemes now have supporting evidence for use as initial therapy. Current challenges include individualized selection of the best immunosuppressive regimen, an unmet need for non-invasive biomarkers of disease activity to inform treatment responses and guide subsequent therapy, holistic patient management in this complex, multisystem disease, and ultimately the development of more targeted therapies directed at specific effector pathways driving glomerular inflammation and damage in order to improve treatment response. In this communication, we review the diagnostic and therapeutic approach to lupus nephritis, as well as evaluation of response to therapy and disease control.
Competing Interests: Declaration of competing interest The authors declare no conflict of interest with the content of this manuscript.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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