[Critical study of the treatment of lupic nephropathies]

Therapeutic indications are not the same in the various types of lupus GN. Most cases of extra-membranous GN and focal GN require no specific treatment. In diffuse proliferative GN, the therapeutic indications depend upon the type of lesions and should always be judged in the light of renal biopsy findings. The use of cortisosteroids in high dosage, which is often followed by regression or even complete disappearence of active renal lesions, has considerably altered the prognosis in lupus nephropathy. Chronic haemodialysis and renal transplantation also make it possible to keep alive patients who have reached the stage of end stage renal failure. It nevertheless remains certain that the incidence and course of lupus nephropathy will be radically modified only when methods are available either to prevent the formation of circulating immune complexes or their deposition in the kidney.