狼疮性肾炎的诊断与治疗:西班牙肾小球疾病研究组(GLOSEN)共识文件总结

Diagnosis and treatment of lupus nephritis: a summary of the Consensus Document of the Spanish Group for the Study of Glomerular Diseases (GLOSEN).

作者信息

Rojas-Rivera Jorge E, García-Carro Clara, Ávila Ana I, Espino Mar, Espinosa Mario, Fernández-Juárez Gema, Fulladosa Xavier, Goicoechea Marian, Macía Manuel, Morales Enrique, Quintana Luis F, Praga Manuel

机构信息

Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.

Departament of Medicine, Universidad Autónoma de Madrid.

出版信息

Clin Kidney J. 2023 Mar 22;16(9):1384-1402. doi: 10.1093/ckj/sfad055. eCollection 2023 Sep.

Abstract

Lupus nephritis (LN) is the most frequent serious manifestation of patients with systemic lupus erythematosus (SLE). Up to 60% of SLE patients develop LN, which has a significant impact on their quality of life and prognosis. Recent advances have improved the diagnostic approach to LN, and new drugs that block specific pathways and kidney damage progression have been developed. Several randomized and well-powered clinical trials have confirmed the efficacy of these agents in terms of proteinuria remission and preservation of kidney function in the medium and long term, with an acceptable safety profile and good tolerance. The combination of different therapies allows for reduction of the dose and duration of corticosteroids and other potentially toxic therapies and leads to an increase in the number of patients achieving complete remission of the disease. This consensus document carried out by the Spanish Group for the Study of Glomerular Diseases (GLOSEN) provides practical and updated recommendations, based on the best available evidence and clinical expertise of participating nephrologists.

摘要

狼疮性肾炎(LN)是系统性红斑狼疮(SLE)患者最常见的严重表现。高达60%的SLE患者会发生LN,这对他们的生活质量和预后有重大影响。最近的进展改进了LN的诊断方法,并且已经开发出了阻断特定途径和肾脏损伤进展的新药。几项随机且样本量充足的临床试验已经证实了这些药物在蛋白尿缓解以及中长期肾功能保护方面的疗效,其安全性可接受且耐受性良好。不同疗法的联合使用能够减少皮质类固醇和其他潜在毒性疗法的剂量及疗程,并使疾病完全缓解的患者数量增加。由西班牙肾小球疾病研究小组(GLOSEN)制定的这份共识文件,基于现有最佳证据以及参与的肾脏病专家的临床专业知识,提供了实用且最新的建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fed/10468759/764c873c1a3c/sfad055fig1.jpg

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