Table 4 Take home points

1.

Kidney disease activity rating scales in systemic lupus erythematosus should include the following:

  •A measure of estimated glomerular filtration rate (eGFR)

   ◦Using consensus-based equation

  •A measure of proteinuria

   ◦Using 24-hour collection

  •Analysis of urine sediment only in conjunction with above

2.

Guidelines for future trials of lupus nephritis:

  •Complete response should be a composite endpoint of the following:

   ◦Proteinuria of less than 0.3 g/day

   ◦eGFR:

     ▪Stable (if more than 60 mL/min per m² at baseline) or

     ▪Improvement of at least 50% (if less than 60 mL/min per m² at baseline)

   ◦Consider repeat biopsy in patients meeting criteria for response or non-response

   ◦Reduction or discontinuation of glucocorticoids

  •Treatment failure should be a composite of the following:

   ◦Need for renal replacement therapy or transplant

   ◦Persistent doubling of serum creatinine

   ◦eGFR decrease by at least 50%

   ◦Renal flare requiring treatment

   ◦Death

  •Design should require 12 to 24 months of follow-up.

  •Detailed guidance on steroid dosing should be provided.