Naslov
Liječenje lupusnog nefritisa
(Treatment of lupus nephritis)

Autori
Novak Srđan

Izvornik
Liječnički vjesnik : glasilo Hrvatskoga liječničkog zbora (0024-3477) 7-8 (2014), 136; 215-219

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, pregledni rad, stručni

Ključne riječi
lupus nefritis; liječenje
(luupusnephritis; treatment)

Sažetak
Abstract Approximately 50% of patients with systemic lupus erythematosus will develop lupus nephritis. Signs of renal involvement such as proteinuria > or = 0.5 g/24 h especially with glomerular hematuria and/or cellular casts should be an indication for biopsy. Goals of immunosuppressive treatment in lupus nephritis is remission with avoidance of treatment-re- lated harms. Initial treatment for patients with class III (+/- V) and class IV (+/- V) LN are intravenous cyclophosphamide (total dose 3 g over 3 months) or mycophenolate mofetil (or mycophenolic acid) in target dose of 3 g/day for 6 months, always in combination with glucocorticoids, wihile in class V, mycophenolate mofetil in combination with glucocorticoids is recommended. In patients improving after initial treatment, mycophenolate mofetil at lower doses (2 g/day) or azatioprine (2 mg/kg/day), both in combination with low dose prednisone for at least 3 years are recommended. In resistant and relapse cases switch from cyclophosphamide to mycophenolate mofetil, or vice versa, or rituximab is recommended.

Izvorni jezik
Hrvatski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA