{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T16:03:52Z","timestamp":1776182632528,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"S4","license":[{"start":{"date-parts":[[2018,10,8]],"date-time":"2018-10-08T00:00:00Z","timestamp":1538956800000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Immunosuppressive therapies for lupus nephritis (LN) have improved significantly over the past few decades, resulting in growing number of choices for treatment individualization and improved renal and patient outcomes. Corticosteroids combined with mycophenolate or cyclophosphamide induces a satisfactory response in a high proportion of Asian and Caucasian patients, but the rate of improvement varies considerably between patients. Relatively low disease flare rate was observed in Chinese patients receiving low\u2010dose prednisolone and mycophenolate maintenance. Short\u2010term results with calcineurin inhibitors (CNI) are encouraging, attributed both to their immunosuppressive efficacy and the action of these agents on podocyte biology leading to more rapid proteinuria suppression. Additional data, especially on the avoidance of nephrotoxicity and metabolic side effects, is required to facilitate selection of patients appropriate for this treatment. Modifications of standard regimens such as reducing corticosteroid exposure or using enteric\u2010coated mycophenolate might help reduce treatment\u2010related toxicities without compromising efficacy. While clinical outcomes of patients have improved with recent therapeutic advances, individual and ethnic variations in disease manifestations and treatment response, as well as the prevention of infections and long\u2010term complications still present challenges to frontline clinicians. Recent data from histological examination and translational studies also suggest that complement activation via the alternative pathway, immune deposition on renal tubular basement membrane, and local inflammatory responses involving resident kidney cells are of pathogenic relevance in LN. The progress of clinical and translational studies has improved not only the understanding of disease mechanisms but also clinical decision making in the management of LN.<\/jats:p>","DOI":"10.1111\/nep.13469","type":"journal-article","created":{"date-parts":[[2018,10,9]],"date-time":"2018-10-09T02:58:14Z","timestamp":1539053894000},"page":"80-83","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Lupus nephritis: An update on treatments and pathogenesis"],"prefix":"10.1111","volume":"23","author":[{"given":"Desmond YH","family":"Yap","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine Queen Mary Hospital, University of Hong Kong  Hong Kong Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Yung","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Queen Mary Hospital, University of Hong Kong  Hong Kong Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"TAK MAO","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Queen Mary Hospital, University of Hong Kong  Hong Kong Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,10,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar3378"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20683"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfs073"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21664"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201940"},{"key":"e_1_2_6_7_1","first-page":"139","article-title":"KDIGO clinical practice guidelines for glomerulonephritis","volume":"2","author":"Kidney Disease: Improving Global Outcomes (KDIGO) Glomerulonephritis Work Group","year":"2012","journal-title":"Kidney Int. 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