NEW YORK, NY — July 29, 2026 — The National Kidney Foundation (NKF) has published a new Kidney Disease Outcomes Quality Initiative (KDOQI) U.S. Commentary on the KDIGO 2024 Clinical Practice Guideline for the Management of Lupus Nephritis, providing practical recommendations for implementing the latest evidence-based approaches to treating one of the most serious complications of systemic lupus erythematosus.
Lupus nephritis (LN), an immune-mediated glomerulonephritis, can lead to chronic kidney disease and kidney failure if not diagnosed and treated early. Approximately 10% of patients with lupus nephritis progress to kidney failure, underscoring the importance of timely diagnosis and effective treatment.
“Lupus nephritis management is becoming increasingly personalized,” said Kerry Willis, PhD, Chief Scientific Officer at NKF. “As new therapies become available, it is critical that clinicians have practical guidance to help patients access the most effective treatments while balancing safety, quality of life, and long-term kidney health.”
Among the most significant changes reflected in the guideline and discussed in the Commentary is the expanded choice of combination immunosuppressive therapy for patients with active, severe lupus nephritis. Clinical trials have demonstrated higher rates of kidney remission with these treatment approaches compared with traditional regimens, without substantial increases in serious adverse events.
“Treatment options for lupus nephritis have expanded significantly in recent years, giving clinicians and patients more tools than ever before to achieve remission and preserve kidney function,” said Gabriel N. Contreras, MD MPH, at the Peggy and Harold Katz Drug Discovery Center at the University of Miami Miller School of Medicine, and co-author of the commentary. “This KDOQI commentary helps translate evolving evidence into practical guidance for clinicians caring for patients with different classes of LN.”
The commentary discusses several newer therapies that are changing the treatment landscape, including belimumab, voclosporin, and recently approved obinutuzumab. Together, these therapies are helping move lupus nephritis care toward a more individualized approach based on disease severity, kidney biopsy findings, patient characteristics, and treatment goals.
“The pace of innovation in lupus nephritis is accelerating,” said Sayna Norouzi, MD, at Loma Linda University Medical Center, and co-author of the commentary. “With newer therapies, we can more effectively individualize treatment, reduce treatment-related setbacks and improve quality of life.”
In addition to treatment recommendations, the commentary emphasizes the importance of early detection and kidney biopsy when appropriate, regular monitoring of kidney function and disease activity, strategies to reduce corticosteroid exposure while maintaining disease control, collaborative care between nephrologists and rheumatologists, and long-term management aimed at preventing disease relapse and preserving kidney function.
The authors note that important questions remain, including the duration and tapering of maintenance immunosuppressive therapy, and how best to manage lupus nephritis during pregnancy and breastfeeding. The commentary also highlights ongoing innovation in the field, including emerging biologic therapies, novel biomarkers for earlier disease detection, and promising research involving chimeric antigen receptor T-cell therapy for autoimmune diseases.
The KDOQI U.S. Commentary on the KDIGO 2024 Clinical Practice Guideline for the Management of Lupus Nephritis is published in the American Journal of Kidney Diseases. To learn more, visit https://www.ajkd.org/article/S0272-63862600921-2/fulltext.
About Kidney Disease
In the United States, CKD remains an under-recognized public health burden that impacts 1 in 7 adults, and 90 percent of those affected are unaware of their condition. Approximately 1 in 3 U.S. adults are at risk for CKD, but less than 20% are assessed with guideline-recommended testing, eGFR and uACR. Risk factors for kidney disease include diabetes, high blood pressure, heart disease, obesity, and family history. People of Black or African American, Hispanic or Latino, American Indian or Alaska Native, Asian American, or Native Hawaiian or Other Pacific Islander descent are at increased risk for developing the disease. Black or African American people are about four times as likely as White people to develop kidney failure. Hispanic and Native American people experience kidney failure at approximately double the rate of White people.
About the National Kidney Foundation
The National Kidney Foundation is revolutionizing the fight to save lives by eliminating preventable kidney disease, accelerating innovation for the dignity of the patient experience, and dismantling structural inequities in kidney care, dialysis, and transplantation. For more information about NKF, visit www.kidney.org.
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Media Contact:
Sam Tyler
National Kidney Foundation
Director of Professional and Science Communications
Phone: 202-279-1505
Email: sam.tyler@kidney.org