Understanding Lupus Nephritis

What is Lupus Nephritis? 

Lupus Nephritis is a condition that can occur when you have Systemic Lupus Erythematosus  (SLE). SLE is an autoimmune disease that can cause inflammation and damage to your skin,  joints, heart, brain and kidneys. This specific type of kidney damage is called Lupus Nephritis, also called Glomerulonephritis. 

SLE triggers your immune system to attack the filtering function of your kidneys. When this  filtering ability is damaged, your kidneys can’t effectively remove excess water and waste  products from your blood. Because Lupus Nephritis is part of an autoimmune disease, a cure does not yet exist.

Does everyone with SLE get Lupus Nephritis? 

Only about half of adults diagnosed with SLE will have Lupus Nephritis. Although the majority  of adults diagnosed with SLE are women, Lupus Nephritis is diagnosed more often in men. Children diagnosed with SLE can also have Lupus Nephritis. 

When is Lupus Nephritis suspected? 

One of the most frequently experienced symptoms of Lupus Nephritis is foamy or bloody urine. Other symptoms include high blood pressure and swelling of the hands, lower  extremities and face. The swelling is due to excess fluids that your kidneys are unable to  remove. The reason for elevated blood pressure with Lupus Nephritis is not fully understood.  Because Lupus Nephritis typically does not occur with kidney pain, it is important to take notice of changes in your urine or swelling and inform your physician. 

How is Lupus Nephritis diagnosed?  

Lupus Nephritis is commonly diagnosed three ways: 

Urine Testing

This test determines if the urine sample contains blood or abnormal levels  of protein. High levels of protein in the urine can have a foamy appearance. You may also  be asked to collect 24 hours of urine to further test your kidney functioning. 

Blood Testing

This test measures the amount of creatinine present, a waste product that kidneys normally remove from your blood.

Kidney Biopsy

This is a medical procedure that uses a long needle to remove a small  sample of kidney tissue. This tissue sample is then analyzed to confirm a Lupus Nephritis  diagnosis. The biopsy will also help determine the severity of damage to your kidneys and the type (class) of Lupus Nephritis that you have. Knowing your specific type of Lupus  Nephritis can help guide your physician in choosing the best treatment options for you. 

How is Lupus Nephritis treated?

Medications used to treat Lupus Nephritis are similar to the immune-suppressing drugs prescribed for SLE. Some examples of immune-suppressing drugs are prednisone and mycophenolate, but there are many others. Refer to Lupus Diagnosis and Treatment for a more comprehensive list of the drug options. You may also be prescribed blood pressure  medication that can assist in protecting your kidneys.

Overall, the goal of Lupus Nephritis treatment is to preserve kidney function and prevent the need for dialysis or kidney transplant. Obtaining an early diagnosis with professional treatment can help suppress your immune system from attacking your kidneys and causing more damage. If Lupus Nephritis is left untreated, scarring and irreversible damage to  your kidneys can occur, along with the need for dialysis or kidney transplant. 

Does Lupus Nephritis have flares and remissions? 

You can experience flares during the course of your Lupus Nephritis. Your urine may contain elevated levels of protein again after months or years of symptom remission. For some people, symptoms may disappear in response to treatment. For others, flares may be more common. The course of your Lupus Nephritis may be very different from the disease progression of someone else. 

Are lifestyle changes helpful? 

If you are a smoker, consider a smoking cessation program. You can also ask your physician if you need to make changes to your diet. Your physician may refer you to a registered dietitian.

The medications you take and other conditions you have will determine the best dietary modifications. For example, if you take corticosteroids, you may need to increase your calcium for bone health. Talk to your physician before starting any supplements, vitamins or herbs because these can interfere with your medications. Also, you might want to consider working with a nutritionist or functional medicine doctor to compliment your traditional medication regimen.

You can also ask your physician to suggest an exercise plan for your specific needs.