Lupus Nephritis, New Treatment Guidelines

Lupus nephritis is a serious complication of systemic lupus erythematosus (SLE), often referred to simply as lupus, and proper treatment is critical to prevent kidney failure. Systemic lupus erythematosus (SLE), an autoimmune disorder, has variable symptoms depending on the organ system which is affected.

SLE is more common in women than men (12:1), African-Americans (10 fold more as compared to whites) and lower income population. Nearly 35% adult newly-diagnosed SLE patients suffer from nephritis, while 50%-60% SLE patients develop nephritis within 10 years of diagnosis. The presence of renal complications results in poor prognosis especially in African-American SLE patients.

Objective  To study the effect of a Chinese herbal decoction (CM), which contained 21 different herbs, on clinical remission in a patient with lupus nephritis and chronic nephrotic syndrome.

Lupus nephritis affects more than one-third (35%) of US adults with SLE at diagnosis, and that percentage climbs to 60% within the first ten years of getting an SLE diagnosis. The survival rate for individuals with lupus nephritis after a decade of SLE is 88%, and the rate is lower for African Americans.

The new guidelines for lupus nephritis from the ACR were compiled after a thorough review of medical literature since 1966. In part they include the following:

Recommendation for kidney biopsy for previously untreated patients who have active lupus nephritis

Adjunctive treatment with ACE (angiotensin-converting enzyme) inhibitors, hydroxychloroquine, and control of blood pressure with a goal of 130/80 mmHg or lower for most SLE patients who have nephritis

Detecting vascular disease in patients with SLE and with kidney abnormalities

Treating nephritis in pregnant women. Active lupus nephritis can worsen the disease, and certain medications used to treat lupus nephritis may cause birth defects.

Maintaining improvement in patients who respond to induction therapy with azathioprine or mycophenolate mofetil, which are immunosuppressive drugs

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