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The management of lupus nephritis as proposed by EULAR/ERA 2019 versus KDIGO 2021
Klinikum Univ, Germany.
Klinikum Univ, Germany.
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Department of Nephrology. Karolinska Inst, Sweden.ORCID iD: 0000-0002-9752-9941
Hosp Univ Fdn Alcorcon, Spain.
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2023 (English)In: Nephrology, Dialysis and Transplantation, ISSN 0931-0509, E-ISSN 1460-2385, Vol. 38, no 3, p. 551-561Article in journal (Refereed) Published
Abstract [en]

In 2019 and 2021, the European League for Rheumatism (EULAR) jointly with the European Renal Association (ERA) and the Kidney Disease: Improving Global Outcomes (KDIGO), respectively, released updated guidelines on the management of lupus nephritis (LN). The Immunology Working Group of the ERA reviewed and compared both updates. Recommendations were either consistent or differences were of negligible clinical relevance for: indication for kidney biopsy, kidney biopsy interpretation, treatment targets, hydroxychloroquine dosing, first-line initial immunosuppressive therapy for active class III, IV (+/- V) LN, pregnancy in LN, LN in paediatric patients and LN patients with kidney failure. Relevant differences in the recommended management relate to the recognition of lupus podocytopathies, uncertainties in steroid dosing, drug preferences in specific populations and maintenance therapy, treatment of pure class V LN, therapy of recurrent LN, evolving alternative drug options and diagnostic work-up of thrombotic microangiopathy. Altogether, both documents provide an excellent guidance to the growing complexity of LN management. This article endeavours to prevent confusion by identifying differences and clarifying discrepancies.

Place, publisher, year, edition, pages
OXFORD UNIV PRESS , 2023. Vol. 38, no 3, p. 551-561
Keywords [en]
autoimmunity; glomerulonephritis; inflammation; lupus; standards
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:liu:diva-183934DOI: 10.1093/ndt/gfab351ISI: 000767415000001PubMedID: 34888694Scopus ID: 2-s2.0-85129606914OAI: oai:DiVA.org:liu-183934DiVA, id: diva2:1648923
Note

Funding Agencies|Deutsche ForschungsgemeinschaftGerman Research Foundation (DFG) [AN372/29-1, 30-1]

Available from: 2022-04-01 Created: 2022-04-01 Last updated: 2024-05-03

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Bruchfeld, Annette

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Division of Diagnostics and Specialist MedicineFaculty of Medicine and Health SciencesDepartment of Nephrology
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