What are the American College of Rheumatology treatment guidelines for lupus nephritis?

Updated: Mar 04, 2019
  • Author: Lawrence H Brent, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Key points of American College of Rheumatology guidelines for managing lupus nephritis are as follows:

  • Patients with clinical evidence of active, previously untreated lupus nephritis should have a renal biopsy to classify the disease according to ISN/RPS criteria

  • All patients with lupus nephritis should receive background therapy with hydroxychloroquine, unless contraindicated

  • Glucocorticoids plus either cyclophosphamide intravenously or mycophenolate mofetil orally should be administered to patients with class III/IV disease; patients with class I/II nephritis do not require immunosuppressive therapy

  • Angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers should be administered if proteinuria reaches or exceeds 0.5 g/day

  • Blood pressure should be maintained at or below 130/80 mm Hg

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