Archivos de Medicina

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Nefritis Lúpica: Nuevas Propuestas Diagnósticas y Controversias para el Desarrollo de Nuevas Terapias

Cristhyan Pacheco-Ayos, Hugo Rafael Corrales- Santander, Heliana Padilla- Santos, María Díaz-Romero, Luis Moscote-Salazar and Libia Manotas-Molina

Objective: Lupus nephritis is one of the most relevant entities in Systemic Lups Erythematosus (SLE) given its high morbimortality and being the only manifestation that is diagnostic for itself, according to current criteria. The diagnosis can be suspected through routine test like accelerated elevation of seric creatinine with a persistent proteinuria. The gold standard for diagnosis is the renal biopsy. In 2003 the ISN/RNP proposed a classification system, which has been criticized for having poor reproducibility and lacking of objectivity in some nomenclatures. In April of current year is published a review of this definitions and is proposed improving the classification system of disease-activity. In order to avoid systematic biopsies, it is searched tissue-specific biomarkers which can faithfully reflect the disease inflammatory activity and have prognosis value. The conventional therapy has been restated as well, because there is still a non-satisfactory margin of patients that progress to chronic kidney disease with need of renal replacement therapy. The tendency of novel clinical trials is focused on the use of biological drugs with other pharmacological targets and also can lower the adverse effect rates associated to conventional cytotoxic drugs currently used.