Three Decades of Progress in Treating Childhood-Onset Lupus Nephritis

Abstract

SummaryBackground and objectives Childhood-onset lupus nephritis (LN) carries a worse renal prognosis compared with adults. Controlled treatment trials in children are lacking. We compared renal and patient survival in a cohort of pediatric patients followed over 3 decades.

Long-term renal outcomes of childhood-onset global and segmental diffuse proliferative lupus nephritis

“…Fourth, response to CYC and MMF in children with IV-G and IV-S must be interpreted with caution as the treatment was non-randomized and based on physician discretion. The retrospective nature of the study impeded the evaluation of important confounding factors on outcome, including immunosuppressive regimen [29,30], relapse [31], nonadherence, and adjunct therapy such as RAAS blockers, anti-hypertensive agents, and statins. Thus, a prospective study with a larger number of subjects is needed to further determine the significance of DPLN subclassification in children.…”

Європейські Доказові Рекомендації По Діагностиці Та Лікуванню Люпус-Нефриту У Дітей: Ініціатива SHARE

“…As there is no robust evidence for the ideal dosing strategy of corticosteroids in proliferative LN in SLE or cSLE, the expert group has not specified this in a recommendation. Most studies in cSLE report the use of oral prednisone 1-2 mg/kg/day (maximum 60 mg/day) as initial dosing in proliferative LN where children < 30 kg mostly are dosed up to 2 mg/kg/day (38,47,48,52,53,64). I.V.…”

Why are kids with lupus at an increased risk of cardiovascular disease?

“…It is a very effective treatment for severe SLE but side effects, including myelosuppression and infertility, limit its use. Roldan showed that individuals treated with cyclophosphamide were 5.4 times less likely to develop atherosclerosis on transesophageal echo [157,158].…”