Management of lupus nephritis in children needs special considerations, but more paediatric data are required

Childhood-onset lupus nephritis (cLN) is a manifestation of systemic lupus erythematosus where patients experience kidney-related symptoms. Induction immunosuppression therapy for cLN aims to achieve disease remission using a combination of corticosteroids with mycophenolate mofetil or cyclophosphamide. Rituximab or calcineurin inhibitors can be added if disease response is unsatisfactory. Maintenance immunosuppression consolidates treatment response to prevent relapse. The evidence for many of these cLN treatment regimens is scarce, particularly in paediatric patients, and treatments often vary between clinics. Newer treatment options such as voclosporin and obinutuzumab also require further investigation to elucidate their utility in management of cLN in children and adolescents.