Lupus care shifts toward earlier, steroid-sparing treatment and closer kidney risk assessment

KDIGO/KDOQI implementation guidance, Spanish Rheumatology Society recommendations, and ERN ReCONNET-SLICC-SLEuro consensus reinforce early recognition, combination therapy, reduced glucocorticoid exposure, and treat-to-target monitoring. Proteinuria below about 0.7 g/day at 12 months correlates with better long-term outcomes, while early retrospective and preclinical findings require validation.