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Updated: Jul 18, 2025
09:43
Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
Published on: June 8, 2022
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Is per-protocol kidney biopsy required in lupus nephritis?
Ioannis Parodis1, Gabriella Moroni2, Marta Calatroni2
1Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Medical Unit of Gastroenterology, Dermatology, and Rheumatology, Karolinska University Hospital, Stockholm, Sweden; Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Autoimmunity Reviews
|August 26, 2023
Summary
Repeat kidney biopsy in lupus nephritis (LN) aids treatment decisions and outcome prediction, especially when clinical and histological responses differ. Harmonizing per-protocol biopsies remains a challenge.
Area of Science:
- Nephrology
- Rheumatology
- Pathology
Background:
- Baseline kidney biopsy is standard for lupus nephritis (LN) classification and differentiating renal involvement.
- Indications for repeat kidney biopsy in LN are debated, with some favoring clinical monitoring.
Purpose of the Study:
- To explore the utility and indications for repeat kidney biopsies in lupus nephritis management.
- To discuss the role of per-protocol biopsies versus clinically indicated repeat biopsies.
Main Methods:
- Review of current literature and clinical practice regarding kidney biopsy in lupus nephritis.
- Discussion of discordance between clinical and histological responses.
Main Results:
- Repeat kidney biopsies can be valuable for assessing treatment response, modulating therapy, and predicting long-term outcomes.
- Per-protocol biopsies at fixed timepoints (e.g., 6 months, 1-2 years) are proposed for evaluating induction and maintenance therapy efficacy.
- Repeat biopsies are also recommended for incomplete responses or to distinguish active from chronic lesions.
Conclusions:
- Repeat kidney biopsy is a useful tool in complex lupus nephritis cases for treatment evaluation and outcome prediction.
- Harmonizing the use of per-protocol biopsies in LN management requires further consideration.
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