What are the ACR guidelines for renal biopsy in patients with systemic lupus erythematosus (SLE)?

Updated: Aug 04, 2021
  • Author: Christie M Bartels, MD, MS; Chief Editor: Herbert S Diamond, MD  more...
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Answer

The 2012 American College of Rheumatology (ACR) guidelines for lupus nephritis recommend renal biopsy for all cases of active, previously untreated lupus nephritis, unless contraindicated. [102] Renal biopsy is used to confirm the presence of lupus nephritis; to aid in classification of systemic lupus erythematosus (SLE) nephritis based on the International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification (see Table 4, below); and to guide therapeutic decisions. [102] Another benefit of renal biopsy is in distinguishing renal lupus from renal vein thrombosis, which may be a complication of antiphospholipid antibody syndrome and require anticoagulation rather than immunomodulatory therapy.


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