Methods for treating lupus nephritis

Good patient information is essential for choosing the best treatment for the kidney disease lupus nephritis.

Dutch researcher Cecile Grootscholten concludes this following her doctoral research into two methods for treating lupus nephritis. She did not demonstrate any major differences but both treatments have pros and cons.

The severity of the kidney disease lupus nephritis varies and the side effects of the treatments differ as well. Therefore Grootscholten advises doctors to thoroughly inform patients in advance about the pros and cons of both treatments. Based on his/her own situation every patient can make a well-considered choice for one of the two treatments.

Grootscholten treated two groups of patients for two years with either drips containing cyclophosphamide (treatment 1) or a combination of drips containing prednisone and oral azathioprine (treatment 2). After 2 years all of the patients were further treated with a low dose of oral prednisone and azathioprine.

The majority of patients faired better than the researchers had expected at the start of the study in 1995. Grootscholten observed that the chance of the disease recurring in the kidneys was greater in the group of patients treated with treatment 2. Shingles also occurred more frequently in this group. However, Grootscholten could not demonstrate a difference between treatment 1 and treatment 2 in terms of long-term kidney function. Moreover in the end, just as many people needed dialysis.

Treatment 1 was experienced as heavier than treatment 2. Yet there were no differences in terms of quality of life or complaints. Treatment 1 is known to increase the risk of infertility and early menopause. Therefore treatment 2 remains as an alternative. A more extensive study is needed for more concrete statements.

Lupus nephritis is a severe kidney inflammation caused by the autoimmune disease systemic lupus erythematodes. The body produces antibodies against its own organs and treatment is absolutely necessary. The condition is rare. Each year 6 in every 100,000 people in the Netherlands develop the disease. Up until 40 years ago patients died from lupus nephritis. Since then various treatment methods have been sought to suppress the inflammation in the kidney. To date no thorough research into the differences between these methods had been carried out.