How do you approach the management of immunosuppression in patients with lupus nephritis that go on to dialysis?
Answer from: at Academic Institution
It depends entirely on their disease status and profile. It is not unusual for patients to have decreased disease activity when they go on HD. If there is still clinical activity though, I maintain them on immune suppressives and prefer mycophenolate mofetil (a major anti-renal transplant rejection ...
As mentioned by Dr. @Vasileios Kyttaris, there are always different approaches based on the individual patient. My experience and it is well reported that most lupus patients do have decreased to no activity when they go on hemodialysis. I do typically leave them on therapy they are on at least for ...
I find it useful in immunologically active lupus patients in renal failure on dialysis to employ the medications the transplant team will use to prevent organ graft rejection. Stabilizing autoimmunity in this manner provides the transplant surgeon with confidence that the lupus patient will sustain ...