Update on the Management of Systemic Lupus Erythematosus from a Pediatric Nephrology Perspective

Although systemic lupus erythematosus (SLE) has a peak incidence in young women, the disease often first presents during childhood. Moreover studies have suggested that patients with disease onset in childhood have a worse prognosis. Considering that renal involvement in SLE is the major determinant of long-term survival and morbidity, the focus of this article will be to review new and exciting approaches in the treatment of pediatric lupus nephritis by referencing the major studies over the last few years. Since membranous lupus nephritis is very different from other forms of lupus nephritis, the treatment of this specific form of renal involvement will not be discussed in great detail. Very few robust clinical trials have investigated the treatment of SLE and lupus nephritis in the pediatric population; hence most recommendations are based on adult clinical trials.