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Partial Renal Response LN — SCE Rheumatology MCQ

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HardSLE & Antiphospholipid SyndromePartial Renal Response LNSCE Rheumatology

A 30-year-old woman with SLE has class III lupus nephritis that achieved partial renal response on Mycophenolate. After 6 months her proteinuria has fallen from 3.5 g/day to 1.8 g/day. According to EULAR 2023 what defines partial renal response and what should be done?

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Correct answer: B — Partial renal response with close reassessment

EULAR 2023 defines partial renal response as ≥50% reduction in proteinuria with stable or improved eGFR and no active urinary sediment. This patient has achieved partial response (3.5 to 1.8 g/day = 49% reduction nearly meeting the threshold). If only partial response is achieved by 12 months the treatment should be intensified: adding Belimumab or a calcineurin inhibitor (Voclosporin Tacrolimus) switching to alternative induction or combining strategies. Complete response (proteinuria <0.5 g/day) remains the ultimate goal. Failure to achieve at least partial response by 6 months predicts poor long-term outcomes.

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