Evidence-based cinical practice guidelines improve delivery of uniform care to patients with and at risk of developing kidney disease, thereby reducing disease burden and improving outcomes. These guidelines are not well-integrated into care delivery systems in most low- and middle-income countries (LMICs). The KDIGO Controversies Conference on Implementation Strategies in LMIC reviewed the current state of knowledge in order to define a road map to improve the implementation of guideline-based kidney care in LMICs. An international group of multidisciplinary experts in nephrology, epidemiology, health economics, implementation science, health systems, policy, and research identified key issues related to guideline implementation. The issues examined included the current kidney disease burden in the context of health systems in LMIC, arguments for developing policies to implement guideline-based care, innovations to improve kidney care, and the process of guideline adaptation to suit local needs. This executive summary serves as a resource to guide future work, including a pathway for adapting existing guidelines in different geographical regions.

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Systemic lupus erythematosus patients who underwent renal biopsies in our institute showed a prevalence of APSN comparable to those in western countries. The presence of APSN was significantly higher in the adult than in the paediatric population. Its association with poor prognostic indicators suggests poor renal outcome. Clinicians should be aware of this condition in order to give proper care to systemic lupus erythematosus patients.

Introduction: Lupus nephritis (LN) is a renal manifestation of systemic lupus erythematosus (SLE), an autoimmune disease more common in females. Clinicopathological manifestations and outcomes of LN in males are uncertain. Objectives: To assess and compare clinicopathological manifestations and outcomes of males and females with LN. Patients and Methods: Patients with LN were identified from database (male 94, female 344). Clinical manifestations, laboratory data, renal histopathology and outcome were retrieved and compared. Results: Compared to females, males were more likely to present with rapidly progressive glomerulonephritis (RPGN) (21.3% versus 11.6%, P = 0.026) and low-serum complement (76.6% versus 63.7%, P = 0.019). While asymptomatic hematuria and/or proteinuria was the second most common clinical manifestation in females (40%), no males presented with this manifestation. Although LN class IV was most common in both groups, males were more likely to have LN class IV with most severe form of renal manifestation than females (50% versus 38.7%, P = 0.048). Males showed tendency for poorer renal survival, but without statistical significance. Conclusion: Males with LN had more severe clinicopathological manifestations than females. Clinicians should be aware of SLE with LN in males in order to make timely diagnosis and treatment.