Clinical and pathological correlations in LN management are crucial for optimal therapeutic decisions. The presence of crescents in renal biopsy is indicative of severe disease and suggests a need for aggressive immunosuppression. Cyclophosphamide is often preferred in such cases due to its efficacy in reducing inflammation and halting disease progression.

In another common situation, patients with nephrotic-range proteinuria (not only those classified under Class V LN) may benefit more from calcineurin inhibitors such as voclosporin. This approach is due to calcineurin inhibitors’ ability to reduce proteinuria effectively while stabilizing renal function.

For patients with a history of CKD or recurrent renal flares, the addition of belimumab to standard of care therapy has shown particularly useful. Belimumab, a monoclonal antibody that inhibits B-lymphocyte stimulator (BLyS), helps in reducing disease activity and preventing further renal damage.

These are the clinical-pathological correlations I am aware of, but are there other correlations or laboratory tips that can help in choosing the best therapy for LN? Any additional insights would be greatly appreciated.