What are the treatment principles for lupus nephritis?

Lupus nephritis is a relatively serious kidney disease nowadays. It is important to pay attention to timely treatment of the disease, otherwise it will cause further damage to the kidneys, leading to serious damage to kidney function and threatening the patient's life. However, when treating lupus nephritis, we must first clarify the treatment principles of lupus nephritis. Only in this way can we ensure that we can achieve better treatment results. The specific treatment principles of lupus nephritis are as follows:

The traditional drug for treating LN is hormones, but clinical practice in recent years has shown that treatment with cytotoxic drugs, especially intermittent pulse therapy with cyclophosphamide (CTX), is much more effective than hormone therapy alone. The treatment of LN is mainly CTX plus hormones, rather than hormones alone.

1. Hormones: Prednisone is generally used as the standard treatment. In the initial treatment stage, adults are given 1 mg/kg ideal body weight, taken once every morning. After 8 weeks, the dosage begins to be reduced by 10% (5 mg) each week, to a low dose (1 mg/kg every other morning), and then taken once every other morning until the maintenance dose (0.4 mg/kg every other morning). For patients with particularly severe or fulminant conditions, 1g of methylprednisolone can be added to 300ml of 5% glucose saline and injected intravenously once a day for 3 consecutive days. Then take a standard course of oral prednisone. This pulse therapy can also be repeated at regular intervals with small doses of prednisone in between.

2. Commonly used cytotoxic drugs include CTX, nitrogen mustard hydrochloride, chlorambucil, azathioprine, etc. Among them, CTX has the best efficacy.

3. The purpose of plasma exchange therapy is to remove antigens, antibodies, immune complexes and other abnormal proteins in plasma, eliminate inflammatory mediators, and improve the phagocytic function of the reticuloendothelial system, thereby controlling the activity of lesions. It can be used for the active phase of diffuse proliferative lupus nephritis that cannot be controlled by combination therapy or shock therapy.

4. Dialysis and kidney transplantation are used for patients with renal failure. After dialysis, their clinical symptoms improve and the dosage of hormones and cytotoxic drugs decreases. However, since other systemic diseases are involved in the patient, the complications of dialysis are more serious. There are many reports of kidney transplantation for LN, but there is a possibility of recurrence of LN in the transplanted kidney.

In fact, the treatment principles for lupus nephritis sometimes need to be adjusted according to the patient's condition. If you want to cure lupus nephritis as soon as possible, the doctor must first make the patient mentally prepared and let the patient realize the great harm of lupus nephritis, so that they can better cooperate with the doctor in the treatment of the disease and get rid of the troubles of lupus nephritis as soon as possible.