Wilhelmus Suzanne, Bajema Ingeborg M, Bertsias George K, Boumpas Dimitrios T, Gordon Caroline, Lightstone Liz, Tesar Vladimir, Jayne David R
Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.
Rheumatology, Clinical Immunology and Allergy, Medical School, University of Crete, Iraklion, Greece Infections and Immunity Division, IMBB-FORTH, Iraklion, Greece.
Nephrol Dial Transplant. 2016 Jun;31(6):904-13. doi: 10.1093/ndt/gfv102. Epub 2015 Apr 28.
In the past years, many (randomized) trials have been performed comparing the treatment strategies for lupus nephritis. In 2012, these data were incorporated in six different guidelines for treating lupus nephritis. These guidelines are European, American and internationally based, with one separate guideline for children. They offer information on different aspects of the management of lupus nephritis including induction and maintenance treatment of the different histological classes, adjunctive treatment, monitoring of the patient, definitions of response and relapse, indications for (repeat) renal biopsy, and additional challenges such as the presence of vascular complications, the pregnant SLE patient, treatment in children and adolescents and considerations about end-stage renal disease and transplantation. In this review, we summarize the guidelines, determine the common ground between them, highlight the differences and discuss recent literature.
在过去几年中,已经开展了许多(随机)试验来比较狼疮性肾炎的治疗策略。2012年,这些数据被纳入了六项不同的狼疮性肾炎治疗指南。这些指南以欧洲、美国和国际为基础,还有一项单独的儿童指南。它们提供了关于狼疮性肾炎管理不同方面的信息,包括不同组织学类型的诱导和维持治疗、辅助治疗、患者监测、缓解和复发的定义、(重复)肾活检的指征,以及诸如血管并发症的存在、妊娠的系统性红斑狼疮患者、儿童和青少年的治疗以及终末期肾病和移植相关考虑等其他挑战。在本综述中,我们总结了这些指南,确定它们之间的共同点,突出差异并讨论近期文献。