NDT Advance Access originally published online on July 28, 2008
Nephrology Dialysis Transplantation 2008 23(10):3056-3060; doi:10.1093/ndt/gfn429
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Renal replacement therapy in lupus nephritis
Division of Nephrology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
Jo H. M. Berden, Division of Nephrology (464), Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands. Tel: +31-24-361-4761; Fax: +31-24-354-0022; E-mail: j.berden@nier.umcn.nl
Keywords: haemodialysis; lupus nephritis; peritoneal dialysis; renal transplantation
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| Introduction |
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Recently, the therapeutic options for the treatment of lupus nephritis (LN) have increased by the promising results of treatment with mycophenolate mofetil (MMF), anti-CD20 and other biological medications. However, whether these treatments will reduce the ultimate development of end-stage renal failure (ESRF) is not known yet. Although compared to prednisone monotherapy, treatment with prednisone and cyclophosphamide or azathioprine reduces the cumulative incidence of ESRF in LN; still 20% of the patients develop ESRF [1]. In this editorial, we will review the results of the various forms of renal replacement therapy [i.e. haemodialysis, peritoneal dialysis and (pre-emptive) renal transplantation] in patients with ESRF due to LN.
| Haemodialysis |
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Initially, there was reluctance to dialyse lupus patients with ESRF because of the systemic nature of the disease and the (previous) use of immunosuppressives. In 1973, Coplon and colleagues documented that haemodialysis and renal transplantation in lupus patients had a favourable short-term prognosis,
Peritoneal dialysis
| Renal transplantation |
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Pre-transplant screening
Cadaveric renal transplantation
| Living donor transplantation |
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Immunosuppressive therapy after renal transplantation
Recurrence of LN after renal transplantation
Lupus disease activity after renal transplantation
| Summary |
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