Despite decades of clinical research aimed at finding the most appropriate
immunosuppressive regime, lupus nephritis (LN) remains one of the major disease
manifestations of systemic lupus erythematosus (SLE) with a great impact on survival and
quality of life. We start this review by defining the disease burden, the real-world challenges
and the poor prognostic factors. We then discuss the current anti-inflammatory, cytotoxic and
biologic therapies, with special emphasis on the need for optimal global care.