A treatment plan is developed on the basis of the biopsy. Mild abnormalities are present in practically all lupus patients, even those with no other clinical or laboratory evidence of kidney involvement. These do not require treatment. Corticosteroids, such as prednisone, have been the basis of treatment for a long time. Their use may result in some improvement in lupus kidney disease, but the improvement is not as long lasting as we would like.
Immunosuppressive drugs reduce the production of antibodies which cause inflammation.
Cytoxan is usually given in combination with prednisone. In many cases it has led to clear improvement in lupus kidney disease. This has been demonstrated by observing improvement in biopsy specimens, reduction in the amount of protein in the urine, and increase in kidney function. Cytoxan is a toxic drug, however, which has many side effects. These include a decrease in the white blood cell count which makes a patient more susceptible to bacterial and other infections.