Table 6. Management of severe proliferative lupus nephritis.

Severe proliferative lupus nephritis	Induction Phase	Maintenance Phase
YES	Intravenous methylprednisolone 0.25-1g/day for 1-3 days followed by oral prednisolone 1mg/kg body weight to a maximum of 80mg/day, tapers over weeks, PLUS Intravenous cyclophosphamide 0.5-1g/m2 monthly for 6 months	Prednisone 5-10mg/day PLUS Mycophenolate mofetil 1-2g/day or Azathioprine 1-2.5mg/kg/day or Cyclosporine 2.5mg/kg/day  if MMF/AZA not tolerated
NO	Oral prednisolone 1mg/kg/day to a maximum of 30mg/day tapper over weeks PLUS Low dose intravenous cyclophosphamide 500mg every 2 weeks for 3 months OR Oral cyclophosphamide 1-1.5 mg/kg/day to a maximum of 150 mg/day for 2-4 months OR Oral mycophenolate mofetil 2-3g/day for 6 months	The maintenance phase is the same as above