Lupus nephritis (LN) is a frequent and severe manifestation of systemic lupus erythematous (SLE). Clinically, LN may occur with extremely variable clinical presentations, ranging from urinary anomalies to rapidly progressive glomerulonephritis. Renal biopsy remains the gold standard for the diagnosis of LN, as the clinical-laboratory presentation doesn’t always correlate with histological data. Treatment of LN includes supportive therapies and targeted immunosuppressive therapies with an induction phase, now called initial treatment and a maintenance phase, now called subsequent treatment. In addition to steroids, mycophenolate mofetil and cyclophosphamide, new drugs such as calcineurin inhibitors (voclosporin) and monoclonal antibodies such as belimumab and rituximab have been introduced in recent decades. Although patient and renal survival have significantly improved from 1970, LN still remains an important negative prognostic factor. Early diagnosis, targeted therapeutic protocols, prevention, and management of complications are the most important factors for the prognosis of these patients.
Keywords: lupus nephritis, immunosuppression, end-stage kidney disease, remission