Algorithm for the Treatment of Membranous Lupus Nephritis Sub-nephrotic-range proteinuria (<3.5g/d, normal serum albumin) and Preserved kidney function 1. Hydroxychloroquine 2. Kidney protective therapy 3. Immunosuppression to treat non-renal SLE 4. Consider immunosuppression to treat class V LN if proteinuria > 1 g/d Close monitoring is recommended: Evaluate for worsening disease, Evaluate for transition to proliferative from of LN Nephrotic proteinuria and/or worsening kidney function 1. Hydroxychloroquine 2. Kidney protective therapy 3. Immunosuppressive therapy to treat class V LN • MMF 2-3 g/d ± corticosteroid to treat extra-renal SLE • Calcineurin inhibitor therapy (cyclosporine or tacrolimus) ± corticosteroids • Cyclophosphamide ± corticosteroids • Multi-target therapy (MMF plus CNI) • Azathioprine ± corticosteroids #Membranous #Lupus #Nephritis #Algorithm #Treatment #management #nephrology
