Lupus Nephritis

1 What is Lupus Nephritis?

The inflammation of the kidney is called lupus nephritis and is mainly caused by lupus erythematous (SLE).

Lupus is an autoimmune disease in which the immune cells attack the body’s own healthy cells. Up to 60 percent of people with SLE are diagnosed with lupus nephritis, which can lead to significant illness and even death. Lupus nephritis often affects people between 20 and 40.

2 Symptoms

The patient with lupus nephritis may experience symptoms like:

  • High blood pressure
  • Foamy urine
  • Edema (swelling or puffiness) in legs, feet, or ankles.
  • Weight gain
  • Rashes, usually on the face
  • Fever
  • Joint pain

3 Causes

Lupus nephritis is mainly caused by lupus erythematous (SLE).

Lupus nephritis is the inflammation of nephrons. Nephrons are the cells of the kidney which are responsible for filtration of the excretory products from the blood. Inflammation leads to improper functioning of the kidneys and thus making it difficult for them to remove the waste products from the blood.

4 Making a Diagnosis

The doctor may suggest the patient to undergo certain tests as described below to make a diagnosis of lupus nephritis:

  1. Urinalysis: This test includes testing of a urine sample for the presence of red blood cells or high protein levels in urine. This can be done by using chemically treated strips which change colour when a high concentration of red blood cells or proteins are present in the urine, therefore, indicating kidney damage.
  2. Blood test: to check the levels of creatinine, which is one of the waste product of normal muscle breakdown excreted by the kidneys and is present in higher quantity when there is kidney damage.
  3. Biopsy: This method involves removal of a part of kidney tissue which is then observed under a microscope.

5 Treatment

Though Lupus nephritis is a serious condition, there are many effective treatment approaches for it.

Some standard treatment approaches includes:

  • The use of corticosteroid prednisone which is used to reduce inflammation in the kidneys. Cyclophosphamide an immunosuppressive or mycophenolate mofetil is usually used along with prednisone.
  • Hydroxychloroquine, a medication for treating SLE, should also be prescribed or continued for people with lupus nephritis.
  • Blood pressure lowering medication like angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are proven to be effective in reducing the blood pressure.

6 Risks and Complications

The treatment methods are generally effective completely or partially controlling the lupus nephritis causing few complications. The patient may experience kidney failure although being treated.

The most severe form of lupus nephritis is called diffuse proliferative nephritis. With this type of illness, the kidneys are inflamed and many white blood cells invade the kidneys, which can cause such severe damage that scars form in the kidneys. Scars are difficult to treat, and kidney function often declines as the number of scars increase.

People who are suspect of developing lupus nephritis should consult their doctor as soon as possible for getting proper diagnosis and treatment at the time. People with lupus nephritis are at a high risk for heart problems, blood vessel problems, and cancer, primarily B-cell lymphoma (a type of cancer that begins in the cells of the immune system).