Management of lupus nephritis

Systemic lupus erythematosus is a multisystemic, autoimmune disorder, with varied clinical and immunological manifestations. Though the predominant onset is in young adulthood especially in females, childhood-onset, with a much broader spectrum of clinical presentations, has been reported with incidence rates ranging from 0.36 to 2.5 per 100,000. Diverse immune system aberrations, both inherited and acquired, contribute to the organ damage. Lupus nephritis is seen in a high proportion of childhood-onset disease and is an important contributor for both short-term and long-term morbidity. Various immunosuppressive regimes with a common goal of achieving and maintaining renal remission have been tested mainly in the adult population. The management of childhood-onset lupus nephritis based on the current available evidence is reviewed and the most appropriate management approach for this group of patients is discussed.