The Link Between Nephritis and Lupus
Recently, the story of a kidney transplant to Selena Gomez made headlines in numerous newspapers and leading websites. Selena’s story of living with lupus had helped to raise awareness about it. In 2015, she revealed that she was suffering from lupus, and within two years everyone learned about her kidney failure. Her story not only raised awareness about lupus but also demonstrated that lupus can be life-threatening and that there has been very little progress made in finding the treatment of lupus. Her story created a kind of fear towards this disease and forced scientific community to pay more attention to this long-neglected medical condition (1).
Since lupus is an autoimmune disease it is difficult to treat lupus. But it is known that lupus is a multi organ disease. In lupus, the immune system fails to recognize its own body tissues and thus attacks them which cause various manifestations of disease. Further this is related to gender and family history. Lupus mostly occurs in childbearing women but it may even occur in teenager. In lupus kidney disease is quite common.
90 percent of people with lupus will also have kidney disease. Even if lupus is diagnosed at an early age, kidney disease will occur. It is not uncommon to have kidney symptoms if lupus occurs at a young age. Kidneys are very important in excreting metabolic wastes and maintaining fluid balance. The fluids and toxic waste may accumulate if kidneys fail to function. End- stage kidney disease may cause glomerulonephritis and one of the most common causes of glomerulonephritis that is slowly emerging is lupus.
End stage renal disease should be diagnosed as early as possible since this condition is life threatening. But since most of the functional cells are not damaged, symptoms of kidney disease do not occur hence in its early stage it is very difficult to diagnosed kidney disease. to diagnose the problem there is no such reliable way since the symptoms may occur only after 90 percent of the kidney has been damaged. Only through laboratory diagnosis, it is possible to diagnose kidney disease at an early stage however this is also a challenge.
The part of the kidney is damaged in lupus. Due to two mechanisms the kidneys in lupus are hurt. The two mechanisms are extrarenal and intrarenal.
Extrarenal- due to deposition of circulating immune complexes, extrarenal damage occurs. These immune complexes are formed when various organs due to lupus are autoimmune damaged. In kidneys they get deposited during the blood filtration. This causes inflammatory disease of the kidneys and the local filtering structures too get damaged.
Intrarenal- the kidney cells are attacked directly by the antibodies. The local inflammatory response further worsens the condition.
But the kidney may not only be damaged due to lupus but also due to toxic effects of medications. Due to poor functioning of local immune system, there is higher chance of getting infections of urinary tract in people with lupus. Also this may occur since the person takes in immune suppressing drugs. Various structures of the kidney may get damaged due to the anti inflammatory drugs.
In all cases of lupus the kidney functions needs to be closely monitored. Some of the symptoms include swelling in feet, legs, hands, ankles and face due to fluid retention. It may also cause high blood pressure. The symptoms depend on how many kidney cells are damaged. Only with the help of laboratory tests this can be determined. These tests include urine test and blood test. Another procedure is kidney biopsy that accurately can determine the kidney disease. If dialysis is needed in a person with lupus it does not mean that the person has end-stage renal disease. It has been shown that if the kind of treatment given is right then many cases can recover and may not need dialysis any further.