Lupus nephritis medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2], Raviteja Guddeti, M.B.B.S. [3]
Overview
Medical Therapy
- Medicines which decrease swelling, lower blood pressure and decrease inflammation by suppressing the immune system.
- Patients may need to monitor intake of protein, sodium, and potassium.
- Patients with severe disease should restrict their sodium intake to 2 grams per day and limit fluid as well.
- Depending on the histology, renal function and degree of proteinuria, patients may require steroid therapy or chemotherapy regimens such as cyclophosphamide, azathioprine, mycophenolate mofetil or cyclosporine.
- Dialysis to control symtopms of kidney failure. There are two types of dialysis, hemodialysis and peritoneal dialysis.
The drug therapy for lupus nephritis depends on the severity of the disease.
- For mild disease, corticosteroids are generally prescribed. More severe disease requires treatment with immunosuppressant agents. The two most commonly used agents are mycophenolate mofetil and intravenous cyclophosphamide. One recent study compared these two drugs.[1]
- The authors showed that patients with Class III or IV disease are more likely to benefit from mycophenolate mofetil as compared to cyclophosphamide. As a result, mycophenolate mofetil is now considered to be the first-line therapy for this disease.
References
- ↑ Ginzler EM, Dooley MA, Aranow C, Kim MY, et al. "Mycophenolate Mofetil or Intravenous Cyclophosphamide for Lupus Nephritis." New England Journal of Medicine. 353:21. 2219-2229. 24 November 2005.