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The management of lupus nephritis as proposed by EULAR/ERA 2019 versus KDIGO 2021

Anders, Hans Joachim ; Loutan, Jerome ; Bruchfeld, Annette ; Fernández-Juárez, Gema M. ; Floege, Jürgen ; Goumenos, Dimitrios ; Turkmen, Kultigin ; van Kooten, Cees ; Frangou, Eleni and Stevens, Kate I. , et al. (2023) In Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 38(3). p.551-561
Abstract

In 2019 and 2021, the European League for Rheumatism (EULAR) jointly with the European Renal Association (ERA) and the Kidney Disease: Improving Global Outcomes (KDIGO), respectively, released updated guidelines on the management of lupus nephritis (LN). The Immunology Working Group of the ERA reviewed and compared both updates. Recommendations were either consistent or differences were of negligible clinical relevance for: indication for kidney biopsy, kidney biopsy interpretation, treatment targets, hydroxychloroquine dosing, first-line initial immunosuppressive therapy for active class III, IV (±V) LN, pregnancy in LN, LN in paediatric patients and LN patients with kidney failure. Relevant differences in the recommended management... (More)

In 2019 and 2021, the European League for Rheumatism (EULAR) jointly with the European Renal Association (ERA) and the Kidney Disease: Improving Global Outcomes (KDIGO), respectively, released updated guidelines on the management of lupus nephritis (LN). The Immunology Working Group of the ERA reviewed and compared both updates. Recommendations were either consistent or differences were of negligible clinical relevance for: indication for kidney biopsy, kidney biopsy interpretation, treatment targets, hydroxychloroquine dosing, first-line initial immunosuppressive therapy for active class III, IV (±V) LN, pregnancy in LN, LN in paediatric patients and LN patients with kidney failure. Relevant differences in the recommended management relate to the recognition of lupus podocytopathies, uncertainties in steroid dosing, drug preferences in specific populations and maintenance therapy, treatment of pure class V LN, therapy of recurrent LN, evolving alternative drug options and diagnostic work-up of thrombotic microangiopathy. Altogether, both documents provide an excellent guidance to the growing complexity of LN management. This article endeavours to prevent confusion by identifying differences and clarifying discrepancies.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
autoimmunity, glomerulonephritis, inflammation, lupus, standards
in
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
volume
38
issue
3
pages
11 pages
publisher
Oxford University Press
external identifiers
  • pmid:34888694
  • scopus:85129606914
ISSN
1460-2385
DOI
10.1093/ndt/gfab351
language
English
LU publication?
yes
additional info
Publisher Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of the ERA.
id
2f39779f-2f82-4150-adf4-0c1d151fc1b0
date added to LUP
2024-01-11 13:57:04
date last changed
2024-05-10 11:09:54
@article{2f39779f-2f82-4150-adf4-0c1d151fc1b0,
  abstract     = {{<p>In 2019 and 2021, the European League for Rheumatism (EULAR) jointly with the European Renal Association (ERA) and the Kidney Disease: Improving Global Outcomes (KDIGO), respectively, released updated guidelines on the management of lupus nephritis (LN). The Immunology Working Group of the ERA reviewed and compared both updates. Recommendations were either consistent or differences were of negligible clinical relevance for: indication for kidney biopsy, kidney biopsy interpretation, treatment targets, hydroxychloroquine dosing, first-line initial immunosuppressive therapy for active class III, IV (±V) LN, pregnancy in LN, LN in paediatric patients and LN patients with kidney failure. Relevant differences in the recommended management relate to the recognition of lupus podocytopathies, uncertainties in steroid dosing, drug preferences in specific populations and maintenance therapy, treatment of pure class V LN, therapy of recurrent LN, evolving alternative drug options and diagnostic work-up of thrombotic microangiopathy. Altogether, both documents provide an excellent guidance to the growing complexity of LN management. This article endeavours to prevent confusion by identifying differences and clarifying discrepancies.</p>}},
  author       = {{Anders, Hans Joachim and Loutan, Jerome and Bruchfeld, Annette and Fernández-Juárez, Gema M. and Floege, Jürgen and Goumenos, Dimitrios and Turkmen, Kultigin and van Kooten, Cees and Frangou, Eleni and Stevens, Kate I. and Kronbichler, Andreas and Segelmark, Mårten and Tesar, Vladimir}},
  issn         = {{1460-2385}},
  keywords     = {{autoimmunity; glomerulonephritis; inflammation; lupus; standards}},
  language     = {{eng}},
  month        = {{02}},
  number       = {{3}},
  pages        = {{551--561}},
  publisher    = {{Oxford University Press}},
  series       = {{Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association}},
  title        = {{The management of lupus nephritis as proposed by EULAR/ERA 2019 versus KDIGO 2021}},
  url          = {{http://dx.doi.org/10.1093/ndt/gfab351}},
  doi          = {{10.1093/ndt/gfab351}},
  volume       = {{38}},
  year         = {{2023}},
}