2024 American College of Rheumatology (ACR) Guideline for the Screening, Treatment, and Management of Lupus Nephritis

被引：3

作者：

Sammaritano, Lisa R. ^{[1
]}

Askanase, Anca ^{[2
]}

Bermas, Bonnie L. ^{[3
]}

Dall'Era, Maria ^{[4
]}

Duarte-Garcia, Ali ^{[5
]}

Hiraki, Linda T. ^{[6
]}

Rovin, Brad H. ^{[7
]}

Son, Mary Beth F. ^{[8
]}

Alvarado, Anthony ^{[9
]}

Aranow, Cynthia ^{[10
]}

Barnado, April ^{[11
]}

Broder, Anna ^{[12
]}

Brunner, Hermine I. ^{[13
]}

Chowdhary, Vaidehi ^{[14
]}

Contreras, Gabriel ^{[15
]}

Felix, Christele

Ferucci, Elizabeth D. ^{[16
]}

Gibson, Keisha L. ^{[17
]}

Hersh, Aimee O. ^{[18
]}

Izmirly, Peter M. ^{[19
]}

Kalunian, Kenneth ^{[20
]}

Kamen, Diane ^{[21
]}

Rollins, Brandi

Smith, Benjamin J. ^{[22
]}

Thomas, Asha ^{[23
]}

Timlin, Homa ^{[24
]}

Wallace, Daniel J. ^{[25
]}

Ward, Michael ^{[26
]}

Azzam, Muayad ^{[27
]}

Bartels, Christie M. ^{[28
]}

Cunha, Joanne S. ^{[29
]}

Dequattro, Kimberly ^{[30
]}

Fava, Andrea ^{[24
]}

Figueroa-Parra, Gabriel ^{[31
,32
]}

Garg, Shivani ^{[28
]}

Greco, Jessica ^{[7
]}

Cuellar-Gutierrez, Maria C. ^{[31
,33
]}

Iyer, Priyanka ^{[34
]}

Johannemann, Andrew S. ^{[35
]}

Jorge, April ^{[36
]}

Kasturi, Shanthini ^{[37
]}

Kawtharany, Hassan ^{[27
]}

Khawandi, Jana ^{[27
]}

Kirou, Kyriakos A. ^{[1
]}

Legge, Alexandra ^{[38
]}

Liang, Kelly V. ^{[27
]}

Lockwood, Megan M. ^{[39
]}

Sanchez-Rodriguez, Alain ^{[31
,40
]}

Turgunbaev, Marat ^{[41
]}

Williams, Jessica N. ^{[42
]}

机构：

[1] Hosp Special Surg, Weill Cornell Med, 535 E 70th St, New York, NY 10021 USA

[2] Columbia Univ, New York, NY USA

[3] UT Southwestern Med Ctr, Dallas, TX USA

[4] Univ Calif San Francisco, San Francisco, CA USA

[5] Mayo Clin, Rochester, MN USA

[6] Hosp Sick Children, Toronto, ON, Canada

[7] Ohio State Univ, Columbus, OH USA

[8] Boston Childrens Hosp, Boston, MA USA

[9] Kaiser Permanente, Sacramento, CA USA

[10] Feinstein Inst Med Res, Manhasset, NY USA

[11] Vanderbilt Univ, Med Ctr, Nashville, TN USA

[12] Hackensack Univ, Med Ctr, Hackensack, NJ USA

[13] Univ Cincinnati, Cincinnati Childrens Hosp, Coll Med, Cincinnati, OH USA

[14] Yale Univ, Sch Med, New Haven, CT USA

[15] Univ Miami, Miami, FL USA

[16] Alaska Native Tribal Hlth Consortium, Anchorage, AK USA

[17] Univ North Carolina, Chapel Hill, NC USA

[18] Univ Utah, Salt Lake City, UT USA

[19] NYU, Grossman Sch Med, New York, NY USA

[20] Univ Calif San Diego, San Diego, CA USA

[21] Med Univ South Carolina, Charleston, SC USA

[22] Florida State Univ, Tallahassee, FL USA

[23] Cent Texas Vet Hlth Care Syst, Temple, TX USA

[24] Johns Hopkins Univ, Baltimore, MD USA

[25] Cedars Sinai, Los Angeles, CA USA

[26] Verier Outcomes Res LLC, Rockville, MD USA

[27] Univ Kansas, Kansas City, MO USA

[28] Univ Wisconsin, Madison, WI USA

[29] Brown Univ, Warren Alpert Med Sch, East Providence, RI USA

[30] Univ Penn, Philadelphia, PA USA

[31] Mayo Clin, Rochester, MN USA

[32] Univ Autonoma Nuevo Leon, Univ Hosp Dr Jose Eleuterio Gonzalez, Monterrey, Nuevo Leon, Mexico

[33] Hosp Salvador, Santiago, Chile

[34] Univ Calif Irvine, Med Ctr, Orange, CA USA

[35] Carolina Arthrit Ctr, Greenville, NC USA

[36] Massachusetts Gen Hosp, Boston, MA USA

[37] Tufts Med Ctr, Boston, MA USA

[38] Dalhousie Univ, Halifax, NS, Canada

[39] Georgetown Univ Hosp, Washington, DC USA

[40] Amer British Cowdray Med Ctr IAP, Dept Internal Med, Mexico City, Mexico

[41] Amer Coll Rheumatol, Atlanta, GA USA

[42] Washington Univ, St Louis, MO USA

来源：

ARTHRITIS & RHEUMATOLOGY | 2025年

关键词：

STAGE RENAL-DISEASE; B-LYMPHOCYTE STIMULATOR; THROMBOTIC MICROANGIOPATHY; IMMUNOSUPPRESSIVE THERAPY; KIDNEY-TRANSPLANTATION; ERYTHEMATOSUS PATIENTS; MYCOPHENOLATE-MOFETIL; INDUCTION TREATMENT; CONTROLLED-TRIAL; PREVALENCE;

D O I：

10.1002/art.43212

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

ObjectiveThe objective is to provide evidence-based and expert guidance for the screening, treatment, and management of lupus nephritis.MethodsThe Core Team developed clinical questions for screening, treatment, and management of lupus nephritis using the PICO format (population, intervention, comparator, and outcome). Systematic literature reviews were completed for each PICO question, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to assess the quality of evidence and to formulate recommendations. The Voting Panel achieved a consensus >= 70% on the direction (for or against) and strength (strong or conditional) of each recommendation.ResultsWe present 28 graded recommendations (7 strong, 21 conditional) and 13 ungraded, consensus-based good practice statements for the screening and management of lupus nephritis. Our recommendations focus on the unifying principle that lupus nephritis therapy is continuous and ongoing, rather than consisting of discrete induction/initial and maintenance/subsequent therapies. Therapy should include pulse glucocorticoids followed by oral glucocorticoid taper and two additional immunosuppressive agents for 3-5 years for those achieving complete renal response.ConclusionThis guideline provides direction for clinicians regarding screening and treatment decisions for management of lupus nephritis. These recommendations should not be used to limit or deny access to therapies, as treatment decisions may vary due to the unique clinical situation and personal preferences of each individual patient.

引用

页数：21

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