Proliferative nephritis in childhood-onset systemic lupus erythematosus: current therapeutic approaches and future perspectives

Abstract

Renal involvement occurs in 50-75% of children with childhood-onset systemic lupus erythematosus (cSLE). Proliferative lupus nephritis (LN) represents the most common pattern of renal involvement in cSLE. Despite aggressive treatment, progression to end stage renal disease can occur in up to 5-10% of children. Over the last 2 decades, tremendous advancements have been made in the treatment of pediatric LN. Special considerations in children need to address the impact of disease and therapy on both physical and psychological growth and development. This review will focus on pivotal clinical trials in the treatment of proliferative LN, with a focus on pediatric data when available.