Renal manifestations of paediatric systemic lupus erythematosus

Dowsett, Thomas and Oni, Louise ORCID: 0000-0002-1532-2390 (2022) Renal manifestations of paediatric systemic lupus erythematosus. Current Opinion in Pediatrics, 34 (2). pp. 203-208.

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Abstract

<h4>Purpose of review</h4>Systemic lupus erythematosus is a lifelong, multisystemic disease. Around a fifth of patients present during childhood. Children are recognized to have a more active disease course with more renal involvement (lupus nephritis) when compared with adults. This review article summarizes the current literature surrounding the management of paediatric lupus nephritis.<h4>Recent findings</h4>International recommendations agree that active, proliferative forms of lupus nephritis are treated with a period of intense induction therapy aimed at inducing remission followed by maintenance immunosuppressive therapy for at least 3 years. Complete response rates in lupus nephritis remain inadequate, in the region of 40-60%, and disease flares are common. Revised histological classification have been proposed but they are yet to be adopted in clinical practice. Lupus nephritis progresses to chronic kidney disease (CKD) stage 5 (kidney failure) in more than 10% of patients within 10 years however the rates of CKD stages 1-4 remain largely unknown. Current trials are focused on the use of biologic agents as adjuncts to current therapy.<h4>Summary</h4>There is an urgent need for better outcomes in paediatric lupus nephritis. The use of biomarkers to monitor lupus nephritis and scientific studies to improve our understanding of the pathogenesis offer hope of improved outcomes.

Item Type:	Article
Uncontrolled Keywords:	juvenile lupus, lupus nephritis, paediatric lupus, systemic lupus erythematosus
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	22 Mar 2022 08:20
Last Modified:	18 Jan 2023 21:10
DOI:	10.1097/mop.0000000000001101
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3151228