Hong Kong Journal of Nephrology
Volume 11, Issue 1 , Pages 5-8, April 2009

Lupus Nephritis—An Enriching Opus

  • Tak Mao Chan

      Affiliations

    • Corresponding Author InformationCorrespondence to: Professor Tak Mao Chan, Yu Professor in Nephrology and Personal Chair, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong SAR. Fax: (+ 852) 2872-5828

Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong SAR

Article Outline

There has been a continuing quest for better treatments for lupus nephritis over the past few decades. Against the backdrop of a veritable clinical exigency, our group has sought to refine existing treatments and to establish new therapies that can improve patient outcomes. Our original research on mycophenolate mofetil, which demonstrated its efficacy and tolerability, has led to a change in the treatment paradigm for proliferative lupus nephritis. This article reviews our clinical research studies in the different types of lupus nephritis.

Key words:  cyclophosphamide , lupus nephritis , mycophenolate mofetil

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REFERENCES 

  1. Li LS , Liu ZH . Epidemiologic data of renal diseases from a single unit in China: analysis based on 13,519 renal biopsies . Kidney Int . 2004;66:920–923
  2. Chan TM , Cheng IKP , Li FK , Wong RWS , Chan KW , Wong KL . Sequential therapy for diffuse proliferative and membranous lupus nephritis: cyclophosphamide and prednisolone followed by azathioprine and prednisolone . Nephron . 1995;71:321–327
  3. Chan TM , Tse KC , Tang CSO , Lai KN , Li FK . Long-term outcome of patients with diffuse proliferative lupus nephritis treated with prednisolone and oral cyclophosphamide followed by azathioprine . Lupus . 2005;14:265–272
  4. Illei GG , Austin HA , Crane M , Collins L , Gourley MF , Yarboro CH , et al.   Combination therapy with pulse cyclophosphamide plus pulse methylprednisolone improves long-term renal outcome without adding toxicity in patients with lupus nephritis . Ann Intern Med . 2001;135:248–257
  5. Chan TM , Li FK , Tang CSO , Wong RW , Fang GX , Ji YL , et al.   Efficacy of mycophenolate mofetil in patients with diffuse proliferative lupus nephritis. Hong Kong-Guangzhou Nephrology Study Group . N Engl J Med . 2000;343:1156–1162
  6. Tse KC , Tang CSO , Lio WI , Lam MF , Chan TM . Quality of life comparison between corticosteroid-and-mycofenolate mofetil and corticosteroid-and-oral cyclophosphamide in the treatment of severe lupus nephritis . Lupus . 2006;15:371–379
  7. Chan TM , Tse KC , Li FK , Tang CSO , Mok MY . Long-term study of mycophenolate mofetil as both induction and maintenance treatment for diffuse proliferative lupus nephritis . J Am Soc Nephrol . 2005;16:1076–1084
  8. Chan TM . Preventing renal failure in patients with severe lupus nephritis . Kidney Int . 2005;94:s116–s119
  9. Contreras G , Pardo V , Leclercq B , Lenz O , Tozman E , O'Nan P , et al.   Sequential therapies for proliferative lupus nephritis . N Engl J Med . 2004;350:971–980
  10. Tse KC , Tang CSO , Lam MF , Yap DYH , Chan TM . Cost comparison between mycophenolate mofetil and cyclophosphamide-azathioprine in the treatment of lupus nephritis . J Rheumatol . 2009;36:76–81
  11. Chan TM . Histological reclassification of lupus nephritis . Curr Opin Nephrol Hypertension . 2005;14:561–566
  12. Tse KC , Li FK , Tang SCW , Tang CSO , Lai KN , Chan TM . Angiotensin inhibition or blockade for the treatment of patients with quiescent lupus nephritis and persistent proteinuria . Lupus . 2005;14:947–952
  13. Chan TM , Li FK , Hao WK , Lui SL , Chan KW , Lai KN . Combined steroid and sequential use of cyclophosphamide followed by azathioprine in the treatment of membranous lupus nephritis with nephrotic syndrome . Lupus . 1999;8:1–7
  14. Tse KC , Lam MF , Tang S , Tang CSO , Lai KN , Chan TM . A pilot study on tacrolimus treatment in membranous or quiescent lupus nephritis with proteinuria resistant to angiotensin inhibition or blockade . Lupus . 2007;16:46–51
  15. Chan TM . Mycophenolate mofetil in the treatment of lupus nephritis-7 years on. Eminence Based Medicine Series . Lupus . 2008;17:617–621

PII: S1561-5413(09)60002-8

doi:10.1016/S1561-5413(09)60002-8

Hong Kong Journal of Nephrology
Volume 11, Issue 1 , Pages 5-8, April 2009

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