Lupus Nephritis Treatment (cont.)
In treating lupus nephritis, special considerations must be given to each individual's particular situation and lifestyle. For example, because cyclophosphamide can damage the ovaries, a woman who desires a future pregnancy might not be a candidate for this treatment. Furthermore, a woman who develops lupus nephritis during pregnancy faces risks of injury to the unborn baby as well as possible permanent kidney impairment from untreated lupus nephritis. Likewise, pregnancies in women with lupus nephritis require intense fetal and maternal monitoring. It should also be noted that birth control pills containing synthetic estrogens are essentially contraindicated (forbidden or not recommended) in women with active lupus nephritis.
Novel approaches to the treatment of lupus nephritis, such as using adenosine analogues, and combinations of existing medications, are being studied. Indeed, many of these approaches are on their way to being put to use in the near future. Some of these treatments, involving the blocking of various molecules that stimulate the cells of inflammation, are being studied at the National Institutes of Health in Bethesda, Maryland.
Finally, attempts are being made to completely reconstitute the immune system in patients with lupus by using bone marrow transplantation and stem cell transplantation. All of these approaches are in the very preliminary stages of development and are not yet accepted as useful. What is clear is that the treatment of lupus nephritis in decades to come will not be the same as it is today.
Last Editorial Review: 8/1/2007