What Is Lupus Nephritis?

Lupus nephritis (also known as lupus glomerulonephritis) can be described as a type of kidney disease that results from systemic lupus erythematosus (SLE). When nephritis occurs, it causes protein to leak from the kidneys. The protein then exits the body through the urine.

Lupus nephritis causes inflammation in the kidneys and has several associated symptoms which can include:

Lupus Nephritis Symptoms

  • Weight gain
  • High blood pressure (hypertension)
  • Foamy and/or dark urine
  • Edema (swelling) of the fingers, feet, ankles, and legs
  • Fluid retention

Previous research estimated that 1/3 of lupus patients experience kidney disease caused by lupus nephritis, but more recent studies suggest that up to 60% of adults and 80% of children with systemic lupus erythematosus suffer from the condition. In approximately 10-30% of patients, lupus nephritis progresses to end stage renal disease (ESRD) within 15 years of diagnosis even with treatment.

Here’s how many long time lupus sufferers are effectively treating lupus symptoms, including nephritis.

Nephritis associated with lupus disease is generally more common in women (largely because 90% of lupus patients are women), but symptoms are often more severe in men and in African Americans.

lupus nephritisIt’s important to keep in mind many patients may not know they have lupus nephritis because it commonly causes no pain in the abdomen or back and may not result in any noticeable symptoms until it worsens.

If you suffer from lupus nephritis, the first symptom you may notice is weight gain and/or swelling which results from fluid retention caused by the loss of protein in the urine. While many lupus symptoms in women and men are mild, easily treated, and non life threatening, kidney nephritis is potentially very dangerous because it can lead to kidney failure.

If the condition is diagnosed, treatment should be sought immediately with the overall goal of improving and normalizing kidney function to prevent complete kidney failure from occurring.

How To Test For Lupus Nephritis

There are many different lupus tests that can identify potential symptoms of lupus disease.

The most common test for diagnosing lupus nephritis is a urinalysis. A urinalysis generally takes place over a period of 24 hours to determine if the kidneys are removing waste and functioning properly. The test looks for proteins and blood cells that are not normally found in urine. The presence of these can indicate kidney damage.

Blood tests such as the blood urea nitrogen (BUN) study and the serum creatinine study can also indicate the presence of lupus nephritis. The kidneys normally remove chemicals such as creatinine and urea from the blood, so when these are present in elevated amounts, it indicates kidney function is declining.

Additional tests like the serum albumin study and the serum sodium study can be used to test for lower blood protein levels and salt/water imbalances, respectively.

If nephritis is suspected, a kidney biopsy can be performed to confirm the diagnosis and to measure the extent of kidney damage that has already taken place. This may involve imaging studies such as an intravenous pyelogram (IVP) or sonogram to determine size and shape of the kidneys and to guide medical professionals performing the biopsy. During a biopsy, a long needle is inserted through the skin and into the kidney to capture a small tissue sample which is then examined under a microscope for damage.

The World Health Organization has developed a system for classifying the level of lupus nephritis based on the results from the biopsy. Their ranking system is as follows:

Lupus Nephritis Classification And Stages

  • Class I – (Normal) – no evidence of lupus nephritis
  • Class II – (Mesangial Nephritis) – most mild form of lupus nephritis; typically responds completely to treatment with corticosteroids
  • Class III – (Focal Proliferative Nephritis) – very early stage of more advanced lupus nephritis; typically treated with high doses of corticosteroids. The outcome is generally excellent.
  • Class IV – (Diffuse Proliferative Nephritis) – advanced stage of lupus nephritis with definite risk of loss of kidney function; typically treated with high doses of corticosteriods combined with immunosuppressive drugs
  • Class V – (Lupus Membranous Nephropathy) – generally associated with excessive protein loss and edema; typically treated with high doses of corticosteroids, with or without immunosuppressive drugs

Depending on the level of kidney damage, treatment for lupus nephritis occurs on an individual basis and may involve any combination of the following:

Lupus Nephritis Treatment

  • Diuretic agents to reduce excess fluid
  • Anti-hypertensive drugs to control high blood pressure
  • Anticoagulation drugs to prevent complications from blood clots
  • Dietary changes to control salt, water, and protein balances
  • Corticosteroids to reduce inflammation
  • Immunosuppressive drugs to reduce the activity of the immune system

Treatment with the above drugs isn’t always successful. In severe cases, kidney dialysis or a kidney transplant may be required to save a patient’s life. In recent years, kidney transplantation has been highly successful against kidney failure that results from lupus nephritis.

Lupus Nephritis Prognosis

In the last decade, the overall prognosis of lupus has improved dramatically. New advancements in the treatment of lupus disease have greatly increased a patient’s odds of living a normal life span even if they suffer from nephritis. The Lupus Foundation Of America reports approximately 80% of patients with lupus nephritis now live a normal life span.

Related posts:

  1. Lupus Symptoms In Women – Do They Differ Between Sexes?
  2. What Is Lupus Disease? Understanding Lupus Symptoms In Women And Men
  3. Lupus Prognosis – What Is The Life Expectancy Of Lupus Disease Patients?

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