The objective of this systematic literature review was to assess the economic burden (direct and indirect costs, and healthcare resource utilization [HCRU]) associated with lupus nephritis (LN), with a specific focus on the costs and HCRU associated with renal flares and end-stage kidney disease (ESKD).

LN was associated with substantially higher direct and indirect costs and HCRU compared with patients without systemic lupus erythematosus (SLE) or non-renal SLE control populations.

The largest gap in the literature is for HCRU and cost data characterizing a renal flare in patients with LN; a flare is likely to result in a period of increased HCRU and therefore optimal management and minimization of flares (i.e., maintaining renal remission) would reduce overall costs.

There are also limited cost and HCRU data on patients with LN and ESKD; presenting challenges for cost-effectiveness analysis where most data were derived from a non-SLE chronic kidney disease population.