Adrenocorticosteroids in lupus nephritis

As is the case in patients who have received renal transplants, steroids are almost universally used as the major drug in the management of patients with lupus renal disease. On theoretical grounds, the use of these drugs is eminently rational. On the basis of clinical experience, there is suggestive evidence that they are useful. On the basis of hard scientific and statistical evidence, justification for their use is lacking. In addition, as in the situation of patients who have received renal transplants, more and more patients are having one of the cytotoxic drugs added to the steroids in the absence of carefully done drug trials.