Challenges to incorporating new therapies in lupus nephritis:
Access
Burden of immunosuppression
Cost effectiveness
Pill burden - adherence
Long term safety
#KidneyWk

But higher BMI is associated with better survival (dry weight# humid weight)

8/9
🎯 Take-home
Switching from traditional eGFR/ACR-based to KFRE-based referral:
✅ Sharpens referral precision
✅ Cuts unnecessary specialist visits by ~25%
✅ Preserves safety with few missed cases
✅ Aligns with KDIGO 2024 — but suggests higher, locally optimized thresholds

A lot of aggressors in this world; pollution, heat waves, metabolic syndrome, aging, medication and iatrogenicity ….// genetic vulnerability