Table 7.

Inductiona treatment of lupus nephritis

Mild Nephritis (WHO classes II, mild III, and V, proteinuria, normal renal function) Severe Nephritis (WHO classes severe III and IV, nephrotic syndrome, reduced renal function ± hypertension)
Prednisolone 10 to 15 mg daily plus azathioprine 2 mg/kg per 24 h—only if renal function depressedPrednisolone 10 to 15 mg daily, i.v. methylprednisolone 1 g daily for 3 d—repeated if necessary
Cyclophosphamide 1 to 3 mg/kg per 24 h orally (depending on renal function)
Transfer to azathioprine 2 mg/kg per 24 h after 12 wk only if clinical vasculitis—plasma exchange 3 to 4 L daily for 7 d
  • a Usually applies to first 12 to 16 wk of treatment.