Treatment Algorithm for Active Proliferative Lupus Nephritis (Class III/IV or Mixed Class III/IV + V) Induction Therapy (Induction Agent plus mod-high dose corticosteroids) Steroid Regimen: 1. IV methylprednisolone 0.25-1 g/d for 1-3 days followed by 2. Oral prednisone 0.5-1 mg/kg/d (max 80 mg/d), taper over several months Induction Immunosuppression Options: 1. Oral MMF 2-3 g/d in divided doses x 6 months 2. IV cyclophosphamide (Euro-Lupus) 500 mg every 2 weeks for 3 months 3. PO cyclophosphamide 1-1.5 mg/kg/d (max 150 mg/d) for 3 months 4. IV cyclophosphamide (NIH Regimen) 0.5-1 g/m2 monthly x 6 months Hydroxychloroquine Kidney Protective Measures #Treatment #Algorithm #Proliferative #Lupus #Nephritis #management #nephrology
