Skip to main content Skip to main navigation menu Skip to site footer

Lupus nephritis and kidney transplantation: past, present and future

  • Dana Pramudya ,
  • Decsa Medika Hertanto ,
  • Afina Thara Pitaloka ,
  • Artaria Tjempakasari ,
  • Pranawa ,

Abstract

Link of Video Abstract: https://youtu.be/d3xTL9HvM2U

 

Background: Systemic lupus erythematosus (SLE), an autoimmune inflammatory disease that affects various organ systems, has a severe form called lupus nephritis (LN). The management of LN has changed over the past few decades due to the discovery of new immunosuppressive drugs and advances in our understanding of the disease process. This study evaluates lupus nephritis and kidney transplantation in the past, present, and future challenges.

Methods: This literature review compiles and elaborates on previous studies from many authors to support future experimental studies, which will be conducted to evaluate the challenges of lupus nephritis and kidney transplantation management according to past, present, and future data.

Results: Treatment strategies for LN typically involve a combination of immunosuppressive medications, such as corticosteroids, cyclophosphamide, and mycophenolate mofetil, to induce and maintain remission. Many LN patients progress to ESRD, necessitating renal replacement therapy (RRT) through dialysis or kidney transplantation. The results of kidney transplantation in LN patients have been progressively improving. Developing novel immunosuppressive agents may improve graft survival and reduce complications in LN patients undergoing kidney transplantation.

Conclusion: The future of kidney transplantation for LN patients appears promising, with emerging research focused on novel immunosuppressive agents, personalized medicine, biomarkers for predicting recurrence and graft rejection, preventive strategies for recurrent LN, and cell-based therapies

References

  1. Tsokos GC. Systemic lupus erythematosus. N Engl J Med. 2011;365(22):2110-2121.
  2. Hahn BH, McMahon MA, Wilkinson A, Wallace WD, Daikh DI, Fitzgerald JD, et al. American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis. Arthritis Care Res (Hoboken). 2012;64(6):797-808.
  3. Yap DYH, Lai KN. The role of cytokines in the pathogenesis of systemic lupus erythematosus - From bench to bedside. Nephrology. 2013;18(4):243-255.
  4. Appel GB, Contreras G, Dooley MA, Ginzler EM, Isenberg D, Jayne D, et al. Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis. Journal of the American Society of Nephrology. 2009;20(5):1103-1112.
  5. Moroni G, Radice A, Giammarresi G, Quaglini S, Gallelli B, Leoni A, et al. Are laboratory tests useful for monitoring the activity of lupus nephritis? A 6-year prospective study in a cohort of 228 patients with lupus nephritis. Ann Rheum Dis. 2009;68(2):234–237.
  6. Ayodele OE, Okpechi IG, Swanepoel CR. Predictors of poor renal outcome in patients with biopsy-proven lupus nephritis. Nephrology. 2010;15(4):482–490.
  7. Bertsias GK, Tektonidou M, Amoura Z, Aringer M, Bajema I, Berden JH, et al. Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis. Ann Rheum Dis. 2012;71(11):1771–1782.
  8. Tektonidou MG, Dasgupta A, Ward MM. Risk of End-Stage Renal Disease in Patients with Lupus Nephritis, 1971-2015: A Systematic Review and Bayesian Meta-Analysis. Arthritis and Rheumatology. 2016;68(6):1432–1441.
  9. Contreras G, Mattiazzi A, Guerra G, Ortega LM, Tozman EC, Li H, et al. Recurrence of lupus nephritis after kidney transplantation. Journal of the American Society of Nephrology. 2010;21(7):1200–1207.
  10. Mok CC, Kwok RCL, Yip PSF. Effect of renal disease on the standardized mortality ratio and life expectancy of patients with systemic lupus erythematosus. Arthritis Rheum. 2013;65(8):2154–2160.
  11. Norby GE, Strøm EH, Midtvedt K, Hartmann A, Gilboe IM, Leivestad T, et al. Recurrent lupus nephritis after kidney transplantation: A surveillance biopsy study. Ann Rheum Dis. 2010;69(8):1484–1487.
  12. Hsieh C, Chang A, Brandt D, Guttikonda R, Utset TO, Clark MR. Predicting outcomes of lupus nephritis with tubulointerstitial inflammation and scarring. Arthritis Care Res (Hoboken). 2011;63(6):865–874.
  13. Tantisattamo E, Maggiore U, Piccoli GB. History of kidney transplantation: a journey of progression and evolution for success. Journal of Nephrology. 2022;35(7):1783–1786.
  14. Bogdanovíc R, Nikolíc V, Pašić S, Dimitrijević J, Lipkovska-Marković J, Erić-Marinković J, et al. Lupus nephritis in childhood: A review of 53 patients followed at a single center. Pediatric Nephrology. 2004;19(1):36–44.
  15. Meier-Kriesche HU, Schold JD, Kaplan B. Long-term renal allograft survival: Have we made significant progress or is it time to rethink our analytic and therapeutic strategies? American Journal of Transplantation. 2004;4(8):1289–1295.
  16. Li K, Yu Y, Gao Y, Zhao F, Liang Z, Gao J. Comparative Effectiveness of Rituximab and Common Induction Therapies for Lupus Nephritis: A Systematic Review and Network Meta-Analysis. Front Immunol. 2022;13:859380.
  17. Mohan S, Palanisamy A, Tsapepas D, Tanriover B, Crew RJ, Dube G, et al. Donor-specific antibodies adversely affect kidney allograft outcomes. Journal of the American Society of Nephrology. 2012;23(12):2061–2071.
  18. Navarra SV, Guzmán RM, Gallacher AE, Hall S, Levy RA, Jimenez RE, et al. Efficacy and safety of belimumab in patients with active systemic lupus erythematosus: a randomised, placebo-controlled, phase 3 trial. Lancet. 2011;377(9767):721-731.
  19. Mok CC. Towards new avenues in the management of lupus glomerulonephritis. Nature Reviews Rheumatology. 2016;12(4):221–234.
  20. Lionaki S, Skalioti C, Boletis JN. Kidney transplantation in patients with systemic lupus erythematosus. World J Transplant. 2014;4(3):176-182.
  21. Pattanaik D, Green J, Talwar M, Molnar M. Relapse and Outcome of Lupus Nephritis After Renal Transplantation in the Modern Immunosuppressive Era. Cureus. 2022;14(1):e20863.
  22. Jorge A, Wallace ZS, Lu N, Zhang Y, Choi HK. Renal Transplantation and Survival Among Patients With Lupus Nephritis: A Cohort Study. Ann Intern Med. 2019;170(4):240-247.
  23. Kute VB, Vanikar AV, Shah PR, Gumber MR, Patel HV, Modi PR, et al. Outcome of live and deceased donor renal transplantation in patients aged ≥55 years: A single-center experience. Indian J Nephrol. 2014;24(1):9-14.
  24. Vincenti F, Rostaing L, Grinyo J, Rice K, Steinberg S, Gaite L, et al. Belatacept and Long-Term Outcomes in Kidney Transplantation. New England Journal of Medicine. 2016;374(4):333–343.
  25. Rovin BH, Solomons N, Pendergraft WF, Dooley MA, Tumlin J, Romero-Diaz J, et al. A randomized, controlled double-blind study comparing the efficacy and safety of dose-ranging voclosporin with placebo in achieving remission in patients with active lupus nephritis. Kidney Int. 2019;95(1):219–231.
  26. Oetting WS, Schladt DP, Guan W, Miller MB, Remmel RP, Dorr C, et al. Genomewide Association Study of Tacrolimus Concentrations in African American Kidney Transplant Recipients Identifies Multiple CYP3A5 Alleles. American Journal of Transplantation. 2016;16(2):574–582.
  27. Manno C, Strippoli GF, Arnesano L, Bonifati C, Campobasso N, Gesualdo L, et al. Predictors of bleeding complications in percutaneous ultrasound-guided renal biopsy. Kidney Int. 2004;66(4):1570-1577.
  28. Tatapudi RR, Muthukumar T, Dadhania D, Ding R, Li B, Sharma VK, et al. Noninvasive detection of renal allograft inflammation by measurements of mRNA for IP-10 and CXCR3 in urine. Kidney Int. 2004;65(6):2390-2397.
  29. Yamada K, Hatakeyama E, Arita S, Sakamoto K, Kashiwabara H, Hamaguchi K. Prediction of chronic renal allograft dysfunction from evaluations of TGFβ1 and the renin-angiotensin system. Clin Exp Nephrol. 2003;7(3):238–242.
  30. Jang HR, Kim M, Hong S, Lee K, Park MY, Yang KE, et al. Early postoperative urinary MCP-1 as a potential biomarker predicting acute rejection in living donor kidney transplantation: a prospective cohort study. Sci Rep. 2021;11(1):18832.
  31. Cockwell P, Chakravorty SJ, Girdlestone J, Savage CO. Fractalkine expression in human renal inflammation. J Pathol. 2002;196(1):85-90.
  32. Ju W, Nair V, Smith S, Zhu L, Shedden K, Song PXK, et al. Tissue transcriptome-driven identification of epidermal growth factor as a chronic kidney disease biomarker. Sci Transl Med. 2015;7(316):316ra193.
  33. Humes HD, Cieslinski DA, Coimbra TM, Messana JM, Galvao C. Epidermal growth factor enhances renal tubule cell regeneration and repair and accelerates the recovery of renal function in postischemic acute renal failure. J Clin Invest. 1989;84(6):1757-1761.
  34. Kok HM, Falke LL, Goldschmeding R, Nguyen TQ. Targeting CTGF, EGF and PDGF pathways to prevent progression of kidney disease. Nat Rev Nephrol. 2014;10(12):700-711.
  35. Ngamjanyaporn P, Worawichawong S, Pisitkun P, Khiewngam K, Kantachuvesiri S, Nongnuch A, et al. Predicting treatment response and clinicopathological findings in lupus nephritis with urine epidermal growth factor, monocyte chemoattractant protein-1 or their ratios. PLoS One. 2022;17(3):e0263778.
  36. Suárez-Fueyo A, Bradley SJ, Tsokos GC. T cells in Systemic Lupus Erythematosus. Current Opinion in Immunology. 2016;43:32–38.
  37. Schioppo T, Ingegnoli F. Current perspective on rituximab in rheumatic diseases. Drug Design, Development and Therapy. 2017;11:2891–2904.
  38. Anolik JH, Campbell D, Felgar RE, Young F, Sanz I, Rosenblatt J, et al. The relationship of FcgammaRIIIa genotype to degree of B cell depletion by rituximab in the treatment of systemic lupus erythematosus. Arthritis Rheum. 2003;48(2):455-459.
  39. Lee YH, Song GG. Relative efficacy and safety of tacrolimus, mycophenolate mofetil, and cyclophosphamide as induction therapy for lupus nephritis: A Bayesian network meta-analysis of randomized controlled trials. Lupus. 2015;24(14):1520–1528.
  40. Wang D, Li J, Zhang Y, Zhang M, Chen J, Li X, et al. Umbilical cord mesenchymal stem cell transplantation in active and refractory systemic lupus erythematosus: a multicenter clinical study. Arthritis Res Ther. 2014;16(2):R79.
  41. Liang J, Zhang H, Hua B, Wang H, Lu L, Shi S, et al. Allogenic mesenchymal stem cells transplantation in refractory systemic lupus erythematosus: A pilot clinical study. Ann Rheum Dis. 2010;69(8):1423–1429.
  42. Hendrawijaya AE, Budiono BP, Riwanto I, Putra A, Prabowo E. The effectivity of bovine colostrum and Mesenchymal Stem Cell (MSC)on the improvement of Alkaline Phosphatase (ALP) and Takeda G-Protein Coupled Receptor-5 (TGR5) level in post-hepatectomy Wistar rats. Bali Medical Journal. 2021;10(2):824-829.
  43. Sumarta NPM, Danudiningrat CP, Hendrianto E, Susilowati H, Karsari D, Rantam FA. Chondrogenic differentiation capacity of human umbilical cord mesenchymal stem cells with platelet rich fibrin scaffold in cartilage regeneration (in vitro study). Bali Medical Journal. 2016;5(3):420-426.
  44. Kartiko BH, Siswanto FM, Purwata TE. Mesenchymal stem cell (MSC) as a potential cell therapy for immune related disease. Bali Medical Journal. 2017;6(1):38-43.

How to Cite

Pramudya, D., Hertanto, D. M., Pitaloka, A. T., Tjempakasari, A. ., & Pranawa. (2023). Lupus nephritis and kidney transplantation: past, present and future. Bali Medical Journal, 12(2), 1802–1807. https://doi.org/10.15562/bmj.v12i2.4456

HTML
12

Total
12

Share

Search Panel