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Nephrol Dial Transplant (2002) 17: 955-957
© 2002 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Cytotoxic therapy of lupus nephritis: recent developments

Frédéric A. Houssiau1, and Michel Jadoul2

1 Departments of Rheumatology and 2 Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, B-1200 Bruxelles, Belgium

Keywords: cyclophosphamide; lupus nephritis

Introduction

Until recently, the primary goal of most therapeutical trials in lupus nephritis (LN) has been to avoid treatment failure, namely death, end-stage renal disease (ESRD) or doubling of serum creatinine (DSC). Fortunately, these poor outcomes have become relatively less frequent, particularly due to the early detection of kidney involvement by regular follow-up in specialized institutions. As an alternative goal to the prevention of treatment failure, prompt achievement and long-term maintenance of remission with less drug-induced morbidity should become the primary treatment objectives. Such an ideal goal is, however, difficult to achieve for several distinct reasons. Firstly, LN is a heterogeneous disease, the prognosis of which is influenced by many variables such as race, gender, socio-economic status, presenting features, initial renal pathology, the occurrence of renal flares, the presence of extra-renal disease, the presence of antiphospholipid antibodies and as of yet unknown factors. Secondly, we still partially ignore the pathophysiological pathways . . . [Full Text of this Article]

The gold standard: the NIH regimen

A challenger: the Euro-Lupus regimen

Future directions

Acknowledgments

Notes

References


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