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- Parodis, Ioannis,1981-Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Medical Unit of Gastroenterology, Dermatology, and Rheumatology, Karolinska University Hospital, Stockholm, Sweden; Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden (författare)
Is per-protocol kidney biopsy required in lupus nephritis?
- Artikel/kapitelEngelska2024
Förlag, utgivningsår, omfång ...
- Elsevier,2024
- printrdacarrier
Nummerbeteckningar
- LIBRIS-ID:oai:DiVA.org:oru-107858
- https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-107858URI
- https://doi.org/10.1016/j.autrev.2023.103422DOI
- http://kipublications.ki.se/Default.aspx?queryparsed=id:237633351URI
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- Språk:engelska
- Sammanfattning på:engelska
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- IP is supported by grants from the Swedish Rheumatism Association (R-969696) , King Gustaf V's 80-year Foundation (FAI-2020-0741), Swedish Society of Medicine (SLS-974449), Nyckelfonden (OLL-974804), Professor Nanna Svartz Foundation (2021-00436), Ulla and Roland Gustafsson Foundation (2021-26), Region Stockholm (FoUI-955483), and Karolinska Institutet.
- Baseline kidney biopsy is recommended in lupus nephritis (LN). Biopsy allows to classify different forms of LN and differentiate other forms of renal involvement, such as tubulo-interstitial nephritis or thrombotic microangiopathy. The indications for repeat biopsy are more controversial. Some authors feel that good clinical monitoring is sufficient to assess prognosis and make therapeutic decisions. Based on the recently demonstrated discordance between clinical and histological response, some physicians recommend per-protocol biopsies either at 6 months in stable patients to verify the response to induction therapy, or after one-to-two years to assess treatment efficacy and tune the duration of maintenance therapy. Others recommend repeating kidney biopsy in case of incomplete response or to discriminate between active and chronic lesions. By definition, a per-protocol kidney biopsy differs from a repeat biopsy in that the former is foreseen at fixed timepoints, regardless of the clinical response. Although any decision should always consider the patient's overall clinical condition, there are no doubts that repeat kidney biopsy represents a useful tool in difficult cases to evaluate treatment response, modulate treatment intensity, and predict long-term renal outcome both in quiescent lupus and during flares. How to harmonize per-protocol biopsies in the LN course remains challenging.
Ämnesord och genrebeteckningar
- MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Reumatologi och inflammation hsv//swe
- MEDICAL AND HEALTH SCIENCES Clinical Medicine Rheumatology and Autoimmunity hsv//eng
- MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Urologi och njurmedicin hsv//swe
- MEDICAL AND HEALTH SCIENCES Clinical Medicine Urology and Nephrology hsv//eng
- Activity index
- Chronicity index
- Flares
- Lupus nephritis
- Renal failure
- Repeated biopsy
Biuppslag (personer, institutioner, konferenser, titlar ...)
- Moroni, GabriellaDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele Milan, Italy; Nephrology and Dialysis Division, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy (författare)
- Calatroni, MartaDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele Milan, Italy; Nephrology and Dialysis Division, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy (författare)
- Bellis, ElisaUnit of Rheumatology, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy (författare)
- Gatto, MarieleUnit of Rheumatology, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy; Unit of Rheumatology, Department of Medicine, University of Padua, Padua, Italy (författare)
- Örebro universitetInstitutionen för medicinska vetenskaper (creator_code:org_t)
Sammanhörande titlar
- Ingår i:Autoimmunity Reviews: Elsevier23:11568-99721873-0183
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