Kidney Biopsy in Lupus Nephritis

Dr. Appenzeller also shared some complementary findings of a study showing histologic changes in repeated renal biopsies at diagnosis and consequent treatment of lupus nephritis. Higher inflammatory type lesions—characterized by neutrophils, fibrinoid necrosis and cellular crescents—usually resolve completely during initial immunosuppression, she said. Standard-of-care treatment, including high-dose glucocorticoids, tends to work well for patients with such lesions.¹²

However, other lesions tend to persist with standard-of-care therapy, although at lower levels, in 50–60% of patients after eight to nine months of treatment. Many patients had other histological lesions even longer, especially hyaline deposits, glomerular crescents and tubulointerstitial inflammation. Such lesions often appear to take months or years to resolve, supporting the current use of long-term maintenance therapy in many patients.¹²

Ruth Jessen Hickman, MD, a graduate of the Indiana University School of Medicine, is a medical and science writer in Bloomington, Ind.

References

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