Treatment of lupus nephritis

Treatment of lupus nephritis

Lupus nephritis is a type of lupus kidney disease and is also relatively common. However, if treated early, recovery can be achieved early, so there is no need to worry too much. There are many treatments for lupus nephritis, but we generally choose a treatment method that suits us based on our actual situation.

Before the treatment of lupus nephritis, it is necessary to diagnose and confirm the disease through various aspects. When patients go to see a doctor, doctors and experts will always look at your medical records in detail and ask about your daily living habits, so as to treat your lupus nephritis according to your specific situation. Below, a nephrologist will introduce several common treatment methods for lupus nephropathy. I hope that patients will take a look.

1. The treatment of lupus nephritis is based on clinical manifestations, laboratory and renal biopsy data. For mild systemic lupus erythematosus (such as only rash, low-grade fever or joint symptoms, etc.) and abnormal immune serological tests, if the urine test is normal and the renal biopsy shows normal or mild glomerular lesions, non-steroidal anti-inflammatory drugs can be used to improve symptoms as appropriate. Generally, there is no need to use glucocorticoids or cytotoxic drugs, and the disease changes should be closely monitored; if the urine test is abnormal and the renal biopsy shows focal segmental mesangial proliferation with segmental necrosis, crescent formation and focal glomerular sclerosis, medium or small doses of glucocorticoids (such as prednisone 20-40 mg/d) can be used, and cytotoxic drugs or tripterygium wilfordii preparations can be added as appropriate.

2. Severe systemic lupus erythematosus (such as high fever, joint pain, weakness and/or lesions rapidly involving the serous membranes, heart, lungs, liver, hematopoietic organs and other organs and tissues) with acute nephritic syndrome or rapidly progressive nephritic syndrome, renal biopsy shows diffuse proliferative glomerulonephritis or crescentic nephritis, and progressive renal function decline, should be given standard hormone therapy plus CTX pulse therapy; or methylprednisolone pulse therapy, 1.0g per day, intravenous injection for 3 to 5 days as a course of treatment, followed by maintenance with moderate doses of prednisone, and repeated once after 7 to 10 days if necessary, generally not more than 3 courses. When the above methods are ineffective or the condition is severe, plasma exchange therapy can be considered; those who cannot use CTX can try cyclosporine A, mycophenolate mofetil, etc. In case of acute severe renal insufficiency, severe hypervolemia, and heart failure, emergency dialysis should be performed to help the patient get through the critical period, create conditions for drug treatment, and buy time.

3. For patients with asymptomatic proteinuria (urine protein>2g/24h), glucocorticoids can be used, and cytotoxic drugs can be added as appropriate. The combination of tripterygium wilfordii preparations and prednisone also has a certain therapeutic effect. For patients with asymptomatic hematuria, tripterygium wilfordii preparations (regular dose or double dose) or CTX can be used for treatment. If conditions permit, it is best to choose medication according to the type of kidney pathology.

We can see that there are three symptoms to watch out for in lupus nephritis, and the treatments corresponding to these three symptoms are different. Everyone needs to pay attention. Many times it is because people do not understand their own symptoms and do not consult a doctor, and they take medicine indiscriminately, which will cause their condition to worsen.