Lupus nephritis is inflammation of the kidney caused by systemic lupus erythematous (SLE). Also called lupus, SLE is an autoimmune disease. Lupus nephritis happens when lupus involves the kidneys.
Up to 60% of lupus patients are likely to develop lupus nephritis. When the kidneys get inflamed, they can’t function normally and can leak protein. If lupus nephritis is not controlled, it can lead to kidney failure.
Symptoms of Lupus Nephritis
Lupus nephritis is a serious problem. Its symptoms, though, are not always dramatic. Noticeable symptom is swelling of the legs, ankles and feet or swelling in the face or hands.
Other symptoms can vary from person to person. They may include:
- High blood pressure
- Weight gain
- Dark urine
- Foamy, frothy urine
- The need to urinate during the night
Not all urinary or kidney problems are due to lupus nephritis. People with lupus may also be prone to urinary tract infections. These cause burning on urination and require antibiotic treatment. Certain lupus medications can also affect the kidneys and cause swelling and other symptoms similar to those of lupus nephritis.
Lupus Nephritis Diagnosis and Treatment
The diagnosis of lupus nephritis begins with a medical history and evaluation of symptoms. The doctor will likely test to confirm a diagnosis. Tests include urine tests, blood tests, imaging tests such as ultrasound, and kidney biopsy.
There are five different types of lupus nephritis. Treatment is based on the type of lupus nephritis, which is determined by the biopsy. Symptoms vary from person to person.
Medications used in treatment can include:
- Corticosteroids. These strong anti-inflammatory drugs can decrease inflammation. Doctors may prescribe these until the lupus nephritis improves. Because these drugs can cause potentially serious side effects, doctors generally taper down the dosage once the symptoms start to improve.
- Immunosuppressive drugs. These drugs, which are related to the ones used to treat cancer or prevent the rejection of transplanted organs, work by suppressing immune system activity that damages the kidneys. These include cyclophosphamide (Cytoxan), azathioprine (Imuran) and mycophenolate (Cellcept).
- Medications to prevent blood clots or lower blood pressure if needed
Even during treatment, loss of kidney function sometimes progresses. On kidney failure, people with lupus nephritis may need dialysis.
Ultimately, it may be necessary to have a kidney transplant. In those cases, people will need additional drugs to keep their immune system from rejecting the transplanted kidney.