Lupus And The Kidneys

Kidney Health Care - David Mangusan Jr, PTRP

Lupus Nephritis

Lupus nephritis is caused by a disease of the immune system called systemic lupus erythematosus (SLE). In lupus nephritis, the kidneys become inflamed. People with the lupus nephritis may also have other disorders in other parts of the body. The immune system of people with SLE attacks healthy cells and tissues. This can damage many parts of the body such as the joints, skin, heart, lungs, brain, and the kidneys.

The cause of SLE is not fully understood. But experts believe that many factors may play a role or trigger the disease.

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Symptoms of lupus nephritis:

Some people with lupus nephritis may have no apparent symptoms. Others may experience
 Weight gain

 High blood pressure

 Swelling around the eyes, legs, ankles, or fingers

 Dark urine

 Blood in the urine (hematuria)

 Proteinuria
Since people with the disease may also have affectations of other parts of the body, other signs and symptoms may be experienced as well, including
 Pain or swelling in joints

 Fever with no known cause

 Muscle pain

 Red rashes, most on the face

 Chest pain when taking a deep breath

 Hair loss

 Mouth ulcers

 Sensitivity to the sun

 Pale or purple fingers or toes

 Swollen glands

 Feeling tired.
Symptoms of lupus may come and go. The times when a person is having symptoms are called flares, which can range from mild to severe. New symptoms may appear at any time.

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Diagnosis of lupus nephritis:

There is no single test to diagnose lupus. But for lupus nephritis, diagnosis may require urine and blood tests as well as kidney biopsy.

 Urine test. This test will reveal if there are blood and proteins in the urine, which may indicate kidney damage.

 Blood test. High levels of creatinine and urea in the blood indicate kidney function is impaired. Creatinine and urea are waste products normally removed by the kidneys from the blood. However, damaged kidneys may not be able to remove these wastes, which can build up in the blood. Your doctor will estimate your glomerular filtration rate (GFR) based on your creatinine score. GFR is a calculation of how efficiently the kidneys are filtering wastes from the blood.

 Kidney biopsy. This is a procedure used that can confirm the diagnosis of lupus nephritis and help to determine how far the disease has progressed. In biopsy, a tissue sample is obtained from the kidney and is examined under a microscope.

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Treatment of lupus nephritis:

Treatment of the disease depends on the symptoms and test results. Treatment options may include medications and dietary changes.

Medications. Your doctor may prescribe drugs to
 Reduce swelling and pain

 Prevent or reduce flares

 Calm the immune system. Use of corticosteroids and additional immunosuppressive drugs that can decrease swelling and inflammation by suppressing the immune system.

 Reduce or prevent damage to joints

 Control blood pressure
Diet. Your doctor may advise you to cut back or limit protein, sodium, and potassium in your diet.

An ultimate goal of treatment for lupus nephritis is to prevent or avoid progression of the disease. It is important that you take an active role in your treatment. Learning about lupus and its effect on other organs of the body is important as well. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, patients who are informed and involved in their own cure:
 Have less pain

 Make fewer visits to the doctor

 Feel better about themselves

 Remain more active.
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References:

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Fast Facts About Lupus. National Institutes of Health, Department of Human Health and Services. September 2005. Available at http://www.niams.nih.gov/Health_Info/Lupus/lupus_ff.asp. Retrieved July 2008.

National Kidney and Urologic Diseases Information Clearinghouse. Lupus Nephritis. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–4622, June 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/lupusnephritis/index.htm. Retrieved July 2008.


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