What Are The Treatment for Lupus Nephritis

The average survival rate for lupus nephritis within 5-10 years is about 75-85% and the prognosis is poorer for those that have massive proteinuria, hypertension and diffuse proliferative nephritis.

Proper treatments for lupus nephritis can greatly improve its prognosis, prolong the patients’ life expectancy and improve their life quality.

General treatment for lupus nephritis

During active phase of lupus nephritis, patients should avoid strenuous activities or over-tiredness and have adequate bed rest. Avoid taking drugs that can induce or worsen the illness conditions such as penicillin, procainamide, etc.

Medicine treatment for lupus nephritis

The aim is to maintain small dosage hormones or cytotoxic drugs to stabilize the illness condition, prevent relapse and reduce side effects.

·Glucocorticoid. It is the mainly adopted drug for lupus nephritis and it can obviously alleviate clinical symptoms and improve prognosis.

·Prednisone. Adult patients need to take 0.8-1mg/kg/d prednisone for 8-12 weeks and the dosage can be reduced to 0.4mg/kg when the illness conditions become stable and this needs to last for 1-2 years or even longer.

·Methylprednisolone. It is suitable for serious pathological changes and needs to be given through intravenous injection. But it can cause infection or retention of water and sodium.

·Cyclophosphamide. It can be used to treat diffuse proliferative lupus nephritis or those that are not sensitive to hormones. However it can cause many side effects---reversible bone marrow suppression, infection, nausea, vomiting, loss of hair, gonad inhibition, hemorrhagic cystitis, carcinogenic, teratogenic, etc.

·Azathioprine. It is usually combined with glucocorticoid and proper dosage is 1-2mg/kg/d.

·Cellcept. It is a new immunosuppressant and can be used to treat refractory lupus nephritis. Its side effects include gastrointestinal reactions, infection and bone marrow suppression, etc.

·Tripterygium glycosides. It is more suitable to be used as maintenance therapy for mild symptoms or after the dosage of hormones and immunosuppressant is reduced. Its main side effects are suppression of bone marrow, gonad inhibition, liver toxicity, menstrual abnormality and gastrointestinal tract symptoms.

·Cyclosporine. 3-5mg/kg/d for 2-32 months and then reduce by 1mg/kg every month until 2.5mg/kg for maintenance therapy. It can cause liver poison, gastrointestinal symptoms, gingival hyperplasia and hairiness.

·Tacrolimus. It can inhibit inflammatory reactions in the kidneys. It can cause muscle tremor, high blood sugar, transient high creatinine and liver damages.

·Leflunomide. It can affect pyrimidine synthesis of the lymphocytes so as to suppress abnormal immune inflammatory reactions. It can cause diarrhea, skin rash, bone marrow suppression, gonad inhibition, liver toxicity or pulmonary fibrosis, etc.

Besides, herbal medicines and immunotherapy are being more and more widely in clinic to treat lupus nephritis which have been proved to have good effects. They can also be combined with the above mentioned treatments to achieve better curative effects and further reduce side effects of simply taking hormones and cytotoxic drugs.