There has been extensive studies and a lot written about the treatmentof Lupus nephritis and there are a lot of opinions regarding the best and safest approach to the therapy. A patient with Lupus Nephritis presents a complex therapeutic approach. Treatment of Lupus nephritis is prolonged, complex and potentially toxic. However, prognosis and outcome of the disease can usually be improved, dramatically, by treatment. It is very important for your doctors to accurately asses the type and severity of your renal involvement. If you have mild glomerulonephritis (Type 1 and Type II WHO classification), you will generally have a good prognosis and may not require therapy or you might respond well to short courses of treatment. More severe forms of lupus nephritis (Type III, IV and V) require aggressive therapy with cytotoxic (cyclophosphamide, mycophenolate mofetil, azathiaprine, tacrolimus), high (pulse) doses of steroids. In some resistant, difficult and severe cases of renal involvement, patients are treated with plasmapheresis. I know that once you start treatment, you will want to see improvement and stop the possibly toxic treatments. Treatment for Lupus Nephritis is usually long, but it can be stopped at such time as immunological tests are back to normal, proteinuria disappears and renal function is stable.
As far as the prognosis of Lupus nephritis, it is pretty much as you have found; five year survival of treated patients with Lupus nephritis from 1990 to 1995 was 82%. That means that only 10-15% of patients with lupus nephritis progressed to end-stage renal failure. Renal failure supervenes usually within the first decade of follow-up. Even patients in renal failure have the option of A proportion of Lupus nephritis patients in endstage renal failure st renal transplant and the recurrence of Lupus nephritis in renal transplant cases is rare.
So, even at its worse..Lupus Nephritis can have a promising prognosis. What stage (TYPE I, II, III, IV or V?)of nehpritis are you in?
I know how frightening all of this can be. We are here for you