Posted On: April 10, 2014
Q. What are the medical treatments recommended for one having Lupus Nephritis in India?
A: “The management of SLE nephritis depends upon the stage of disease. In India the management strategy follows the guidelines recommended by American College of Rheumatology (ACR).
Well, there are 6 stages.
Stage 1 and 2 are managed with oral medication e.g. prednisolone, hydroxychloroquine with or without angiotensin converting enzyme inhibitors/ angiotensin receptor blockers. The severe forms of lupus nephritis are stage 3 and above for which treatment is more complicated. Treatment for stage 6 is not preferred because there is no improvement with such therapy.
The strategy divided into two phases… Induction and maintenance phase. The flow chart for treatment is as follows–
ACR guideline for Class III/IV induction therapy. MMF – mycophenolate mofetil. cyclophosphamide (CYC), GC -glucocorticoids; IV – intravenous, AZA – azathioprine; BSA – body surface area.
Healing procedure of class V devoid of proliferative changes and with nephrotic range proteinuria (_3 gm/24 hours)(ACR guideline).
Stage 6 requires renal replacement therapy (e.g. dialysis, renal transplantation).”