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Lupus Nephritis Response — SCE Rheumatology MCQ

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ModerateSLE & Antiphospholipid SyndromeLupus Nephritis ResponseSCE Rheumatology

A 32-year-old woman with SLE and positive anti-dsDNA develops class IV lupus nephritis. She is started on Mycophenolate and glucocorticoids. According to EULAR 2023 what defines complete renal response?

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Correct answer: B — Proteinuria below 0.5 g/day with stable GFR

Complete renal response in lupus nephritis is defined as proteinuria <0.5 g/24 hours (or protein-to-creatinine ratio <50 mg/mmol) with stable or improved eGFR. Partial response is defined as ≥50% reduction in proteinuria with stable or improved eGFR. Failure to achieve at least partial response by 6 months predicts poor long-term renal outcomes. EULAR 2023 emphasises that proteinuria is the key monitoring parameter. Serological improvement (anti-dsDNA normalisation complement normalisation) supports but does not define renal response.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions