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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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Severe lupus nephritis in the present days
Gabriella Moroni1,2, Marta Calatroni1,2, Claudio Ponticelli3
1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele Milan, Italy.
Frontiers in Nephrology
|September 7, 2023
Summary
Lupus nephritis (LN), a severe manifestation of systemic lupus erythematosus (SLE), shows changing clinical presentations but persistent histological activity. New therapies offer improved renal response with reduced corticosteroid use, necessitating tailored treatment strategies.
Area of Science:
- Nephrology
- Rheumatology
- Immunology
Background:
- Lupus nephritis (LN) is a critical complication of systemic lupus erythematosus (SLE), often leading to end-stage kidney disease.
- Epidemiological shifts show reduced renal insufficiency at presentation in developed nations, with more mild urinary abnormalities.
- Despite clinical changes, histological assessment reveals persistent active kidney lesions, though chronic lesions are decreasing.
Purpose of the Study:
- To analyze the evolving epidemiology and clinical presentation of lupus nephritis.
- To evaluate the impact of recent therapeutic advancements on renal outcomes.
- To highlight the need for personalized treatment strategies in severe LN.
Main Methods:
- Review of epidemiological trends in lupus nephritis presentation.
- Analysis of histological findings from kidney biopsies.
- Evaluation of data from recent randomized controlled trials on novel drug therapies.
Main Results:
- A trend towards milder clinical presentations of LN in developed countries, but with unchanged active histological lesions.
- Emergence of complex, severe LN types requiring specific attention.
- Demonstrated efficacy of new drugs combined with standard therapy, improving short- and medium-term renal response rates.
- Reduced corticosteroid dosage achieved with new therapeutic regimens, mitigating chronic organ damage.
Conclusions:
- Optimized therapeutic strategies combining established and novel drugs are crucial for managing severe lupus nephritis.
- Personalized treatment approaches, considering demographic, clinical, and histological factors, are essential for improving patient prognosis.
- Ongoing research and clinical trials are vital for refining LN management and improving long-term renal survival.
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