Lupus nephritis type IV is usually not completely curable, but it can be treated with drugs or plasma exchange to slow down the disease progression. Lupus nephritis type IV is a diffuse lupus nephritis with more than 50% glomerular involvement seen on light microscopy. There is extensive cellular proliferation (endothelial and mesangial cells) and cellular infiltration, with widespread and severe nuclear fragmentation and crumpling. The basement membranes of the glomerular capillaries are thickened and stiff, with wire-loop changes, and immunofluorescence reveals extensive deposition of large particles of immunoglobulin and complement in the peritubular zone and capillaries. Patients with this type of nephritis often have crescent formation, and if most of the glomeruli have crescent formation, the diagnosis of lupus crescentic nephritis can be made. Lupus nephritis type IV is usually not completely curable, but after active standardized treatment, patients can relieve clinical symptoms to a certain extent, but it is also easy to relapse, and the condition will gradually aggravate, so it can’t achieve the goal of complete cure. Lupus nephritis type IV patients can usually be treated with glucocorticosteroids such as prednisone acetate, methylprednisolone, etc., as well as immunosuppressants such as cyclophosphamide, mertiomacrophenol ester, etc.; plasma exchange is also feasible if necessary. All of the above drugs should be used under the guidance of a doctor. It is recommended that patients with lupus nephritis should consult a doctor in time and follow the doctor’s instructions to avoid aggravating the condition.