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Ethnicity Variation in the Treatment of Pediatric Lupus Nephritis

Volume 11 - Issue 2

Aanchal Shrestha1, Ruochen Che1 and Zhang Aihua*1,2

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    • 1Department of Nephrology, Children’s Hospital of Nanjing Medical University, Nanjing 210008, China
    • 2Nanjing Key Laboratory of Pediatrics, Children’s Hospital of Nanjing Medical University, Nanjing 210008, China
    • *Corresponding author: Aihua Zhang, Department of Nephrology, Children’s Hospital of Nanjing Medical University, China

Received: November 05, 2018;   Published: November 19, 2018

DOI: 10.26717/BJSTR.2018.11.002062

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Systemic lupus erythematosus (SLE) is known as a complex autoimmune disorder which is characterized by chronic systemic inflammation resulting from antibodies directed against self-antigens, immunity dysfunction and immune complex formation affecting multi-organ system. Lupus nephritis (LN) is a serious component of SLE in which 40-80% are diagnosed in childhood and exerts adverse impact on long-term renal and patient survival. African-Americans (AA), Hispanics, Asians, and non-Caucasians are high-risk populations with higher prevalence and severe disease. Despite the similarities in adults, childhood-onset LN tends to have more active onset and severe disease activity requiring timely recognition and proper treatment. Over the past 2 decades, huge progress has been made in the treatment of childhood LN. Ethnicity has a quite well-defined effect on the response to treatment for which special considerations must be taken in treatment strategy. This review will discuss the current therapies of LN in clinical practice and shows a comparison of treatment responses in different ethnicities.

Keywords : Lupus Nephritis; Systemic Lupus Erythematosus; Pediatric; Ethnicity; Immunosuppressive Treatment

Abbreviations : SLE: Systemic Lupus Erythematosus; LN: Lupus Nephritis; AA: African-Americans; CYC: Cyclophosphamide; NIH: National Institutes of Health; IV: Intravenous; ELNT: Euro-Lupus Nephritis Trial; MMF: Mycophenolate Mofetil; RCT: Randomized Controlled Trial; ALMS: Asperva Lupus Management Study; AZA: Azathioprine; CNI: Calcineurin Inhibitors (CNIs); RTX: Rituximab; HCQ: Hydroxychloroquine; ACR: American College of Rheumatology; KDIGO: Kidney Disease Improving Global Outcomes; EULAR: European League Against Rheumatism

Introduction| Treatment| Adjunctive Therapy| Conclusion| Acknowledgment| References|