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[狼疮性肾炎的诊断与治疗 - 2023]

[Diagnostic and therapy of lupus nephritis - 2023].

作者信息

Odler Balazs, Pollheimer Marion J, Kronbichler Andreas, Säemann Marcus D, Windpessl Martin, Gauckler Philipp, Rudnicki Michael, Zitt Emanuel, Neumann Irmgard, Lhotta Karl, Eller Kathrin

机构信息

Abteilung für Nephrologie, Innere Medizin, Medizinische Universität Graz, Graz, Österreich.

Institut für Pathologie, Medizinische Universität Graz, Graz, Österreich.

出版信息

Wien Klin Wochenschr. 2023 Aug;135(Suppl 5):675-687. doi: 10.1007/s00508-023-02263-8. Epub 2023 Sep 20.

DOI:10.1007/s00508-023-02263-8
PMID:37728652
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10511585/
Abstract

The manuscript summarizes the consensus of the Austrian Society of Nephrology on the diagnosis and therapy of lupusnephritis, which is built on existing studies and literature. We discuss in detail the immunosuppressive treatment in proliferative forms of lupusnephritis (III and IV ± V) and in pure lupusnephritis V with nephrotic-range proteinuria. Furthermore, the supportive medication in lupusnephritis is summarized in the consensus. The figures were designed to provide the reader a guidance through the therapeutical approach in lupusnephritis for the daily practice.

摘要

本手稿总结了奥地利肾脏病学会关于狼疮性肾炎诊断和治疗的共识，该共识基于现有研究和文献。我们详细讨论了增殖性狼疮性肾炎（III和IV±V型）以及伴有肾病范围蛋白尿的单纯狼疮性肾炎V型的免疫抑制治疗。此外，该共识还总结了狼疮性肾炎的支持性药物治疗。这些图表旨在为读者在日常实践中针对狼疮性肾炎的治疗方法提供指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddde/10511585/8325478cf3bd/508_2023_2263_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddde/10511585/f32234ea346a/508_2023_2263_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddde/10511585/8325478cf3bd/508_2023_2263_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddde/10511585/f32234ea346a/508_2023_2263_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddde/10511585/8325478cf3bd/508_2023_2263_Fig2_HTML.jpg

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本文引用的文献

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Weaning of maintenance immunosuppressive therapy in lupus nephritis (WIN-Lupus): results of a multicentre randomised controlled trial.狼疮肾炎维持性免疫抑制治疗的撤药（WIN-Lupus）：一项多中心随机对照试验的结果。
Ann Rheum Dis. 2022 Oct;81(10):1420-1427. doi: 10.1136/annrheumdis-2022-222435. Epub 2022 Jun 20.
2
Survival analysis of mortality and development of lupus nephritis in patients with systemic lupus erythematosus up to 40 years of follow-up.系统性红斑狼疮患者 40 年随访期间死亡率和狼疮肾炎发展的生存分析。
Rheumatology (Oxford). 2022 Dec 23;62(1):200-208. doi: 10.1093/rheumatology/keac218.
3
Systemic Lupus Erythematosus Management in Pregnancy.
妊娠期系统性红斑狼疮的管理
Int J Womens Health. 2022 Feb 15;14:199-211. doi: 10.2147/IJWH.S282604. eCollection 2022.
4
Expert Perspective: An Approach to Refractory Lupus Nephritis.专家视角：难治性狼疮肾炎的治疗方法。
Arthritis Rheumatol. 2022 Jun;74(6):915-926. doi: 10.1002/art.42092. Epub 2022 Apr 25.
5
The management of lupus nephritis as proposed by EULAR/ERA 2019 versus KDIGO 2021.EULAR/ERA 2019 与 KDIGO 2021 提出的狼疮肾炎治疗管理。
Nephrol Dial Transplant. 2023 Feb 28;38(3):551-561. doi: 10.1093/ndt/gfab351.
6
Incidence of Kidney Replacement Therapy and Subsequent Outcomes Among Patients With Systemic Lupus Erythematosus: Findings From the ERA Registry.系统性红斑狼疮患者的肾脏替代治疗发生率及后续结局：来自ERA注册研究的结果
Am J Kidney Dis. 2022 May;79(5):635-645. doi: 10.1053/j.ajkd.2021.09.016. Epub 2021 Nov 6.
7
B-cell depletion with obinutuzumab for the treatment of proliferative lupus nephritis: a randomised, double-blind, placebo-controlled trial.奥滨尤妥珠单抗治疗增生性狼疮肾炎的 B 细胞耗竭：一项随机、双盲、安慰剂对照试验。
Ann Rheum Dis. 2022 Jan;81(1):100-107. doi: 10.1136/annrheumdis-2021-220920. Epub 2021 Oct 6.
8
Executive summary of the KDIGO 2021 Guideline for the Management of Glomerular Diseases.KDIGO 2021肾小球疾病管理指南执行摘要。
Kidney Int. 2021 Oct;100(4):753-779. doi: 10.1016/j.kint.2021.05.015.
9
KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases.KDIGO 2021肾小球疾病管理临床实践指南。
Kidney Int. 2021 Oct;100(4S):S1-S276. doi: 10.1016/j.kint.2021.05.021.
10
Efficacy and safety of voclosporin versus placebo for lupus nephritis (AURORA 1): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial.与安慰剂相比，voclosporin治疗狼疮性肾炎的疗效和安全性（AURORA 1）：一项双盲、随机、多中心、安慰剂对照的3期试验。
Lancet. 2021 May 29;397(10289):2070-2080. doi: 10.1016/S0140-6736(21)00578-X. Epub 2021 May 7.