Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 3 2025 01 07 422 424 Achmad Marwan Trainee Consultant Intensive Care Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Bambang Semedi Department of Anesthesiology and Reanimation, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Maulydia Maulydia Department of Anesthesiology and Reanimation, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. 2024 09 09 2024 10 01 Lupus nephritis, a severe complication of systemic lupus erythematosus (SLE), often leads to significant renal impairment requiring intensive care. The management of lupus nephritis in the intensive care unit of Dr. Soetomo General Hospital extends to various patient populations, including adult patients undergoing hemodialysis and lupus nephritis with sepsis. The management of lupus nephritis entails not only renal complications but also the challenges associated with hemodialysis. Close monitoring of fluid and electrolyte balance is essential, along with adjustments in dialysis parameters to optimize renal function and prevent further complications. Additionally, we may need to tailor immunosuppressive therapy to the patient's renal replacement therapy regimen, taking into account the potential impact on drug clearance and toxicity. Patients with SLE undergoing immunosuppressive therapy are also at risk of developing infections, which can progress to sepsis and require more intensive care. Treatment of lupus nephritis in ICU generally necessitates intensive care, which includes hemodialysis and sepsis control. https://aacc.tums.ac.ir/index.php/aacc/article/view/1084