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Lupus Nephritis (LN)

The 2024 Clinical Practice Guideline for the Management of Lupus Nephritis is a focused update of the lupus nephritis (LN) chapter of The KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases. The Lupus Nephritis Guideline was published in the January 2024 issue of Supplements to Kidney International, with an Executive Summary published in the main pages of the journal. The guideline was co-chaired by Brad Rovin, MD (United States) and Jürgen Floege, MD (Germany), who co-chaired the 2021 Glomerular Diseases Guideline and will co-chair future chapter updates. 

Drawing from the latest approvals of belimumab and voclosporin by the FDA and EMA, the guideline provides updated recommendations and practice points for using these new therapies as add-on immunosuppressive agents in the management of LN. The development of the guideline followed an explicit process of evidence review and appraisal. Treatment approaches and guideline recommendations were based on systematic reviews of relevant studies. Appraisal of the quality of the evidence and the strength of recommendations followed the ‘Grading of Recommendations Assessment, Development and Evaluation’ (GRADE) approach. Graded recommendations are categorized by strength and certainty of evidence, while practice points serve as expert guidance to complement these recommendations. Limitations of the evidence are discussed, with areas for future research also presented. As part of KDIGO’s transparent guideline development process, the draft guideline was made available for public comment in March 2023, receiving valuable feedback, which was meticulously reviewed and considered by the Guideline Work Group.

Please visit the KDIGO Glomerular Diseases Guideline website for more resources.