Treatment outcomes of Pediatric Lupus Nephritis Class III and IV in National Children’s Hospital

Abstract

Treatment of lupus nephritis (LN) remains challenging. A prospective observational study on the children with newly diagnosed LN class III and IV from 9/2019 to 9/2021 intended to examine the efficacy of MMF with corticosteroids as induction therapy for pediatric lupus nephritis class III and IV. All patients received 3 days of pulse methylprednisolone followed by a tapering course of oral prednisone therapy in combination with Mycophenolate mofetil (MMF) 1200mg/m2/day (max 2g/day). Those with urine protein-creatinine ratio (uPCR) > 200mg/mmol and normal renal function after 1-month treatment received MMF and low dose Calcineurin Inhibitors (CNI). There were 57 children who were 75.4% females, 42.1% of children in class III, and 57.9% in class IV. The mean age was 10.88. 82.5% of patients r eceived Corticosteroid and MMF, and 10 children were treated with Corticosteroid, MMF, and CNI. Early responses at week 12 were achieved by 71.9%. The overall response was seen in 93.3% of patients after 6 months of therapy ( 42.2% complete response and 51.1% partial response). 2 patients (3.5%) had infections. MMF is effective in the treatment of children with proliferative lupus nephritis in induction therapy.