van Tellingen A, Voskuyl A E, Vervloet M G, Bijl M, de Sévaux R G L, Berger S P, Derksen R H W M, Berden J H M
Department of Nephrology, VU University Medical Centre, Amsterdam, the Netherlands.
Neth J Med. 2012 May;70(4):199-207.
Proliferative lupus nephritis is a strong predictor of morbidity and mortality in patients with systemic lupus erythematosus. Despite improvements in the management of lupus nephritis, a significant number of the patients do not respond to immunosuppressive therapy and progress to end-stage renal failure. In order to optimise the diagnostic strategy and treatment of patients with proliferative lupus nephritis, guidelines are needed. In this review, the Dutch Working Party on Systemic Lupus Erythematosus provides recommendations regarding four important areas in patients with proliferative lupus nephritis: I) indications for a first renal biopsy, II ) definitions of treatment response, III ) selection of treatment options, and IV) indications for a repeat biopsy.
增殖性狼疮性肾炎是系统性红斑狼疮患者发病和死亡的有力预测指标。尽管狼疮性肾炎的治疗有所改善，但仍有相当数量的患者对免疫抑制治疗无反应并进展为终末期肾衰竭。为了优化增殖性狼疮性肾炎患者的诊断策略和治疗，需要指南。在本综述中，荷兰系统性红斑狼疮工作组针对增殖性狼疮性肾炎患者的四个重要领域提供了建议：I）首次肾活检的指征，II）治疗反应的定义，III）治疗方案的选择，以及IV）重复活检的指征。
