GLANCE survey: awareness and implementation of the GLOSEN recommendations for the diagnosis and treatment of lupus nephritis

In 2023, the Spanish Society of Nephrology's Glomerular Diseases Study Group (GLOSEN) published a consensus document containing the most pertinent information and clinical recommendations for the diagnosis, treatment, and follow-up of lupus nephritis (LN). GLANCE is a project that emerged from the need to evaluate the extent of knowledge and application of these GLOSEN recommendations in routine clinical practice for the management of LN. To achieve this, an online self-administered survey was conducted to gather opinions on the recommendations and assess their impact on clinical practice. Fifty-one Spanish nephrologists (n = 51) with more than three years of experience in managing LN and handling more than one LN patient per month, participated in the survey. All participants demonstrated a comprehensive understanding and high overall acceptance of the GLOSEN recommendations. However, discrepancies were noted regarding criteria for partial remission and relapse, as well as treatment goals during the initial months of progression, underscoring the need for a more detailed consensus. Other findings highlighted the limited number of nephrologists using specific scales to assess extrarenal manifestations and the tendency to extend immunosuppressive treatments beyond the recommended 3-5-year period outlined in the document. This emphasizes the necessity for further studies on the discontinuation of these drugs and their association with the risk of relapse in LN.