Approach to Membranous Lupus Nephritis: A Survey of Pediatric Nephrologists and Pediatric Rheumatologists

Objective. To describe treatment practices for childhood pure membranous lupus nephritis (MLN). Methods. Survey study of Childhood Arthritis and Rheumatology Research Alliance and American Society of Pediatric Nephrology members. Results. There were 117 respondents who completed the survey (60 pediatric nephrologists, 57 pediatric rheumatologists). Steroids and nonsteroid immunosuppression (NSI) were routinely used by the majority for MLN. Mycophenolate mofetil was the favored initial NSI. Nephrologists used steroids (60% vs 93%) and NSI (53% vs 87%) less often than did rheumatologists for MLN without nephrotic syndrome (NS). Conclusion. Pediatric rheumatologists and nephrologists both recommend steroids and NSI for children with MLN, with or without NS.