Lupus nephritis (nef-RYE-tis) is the medical name for kidney swelling and irritation that is caused by lupus. Lupus is an autoimmune disease. Autoimmune diseases cause your immune system to attack your own healthy cells. When your immune system attacks your kidneys, they get damaged. The damage can be very serious. The most severe kind of lupus nephritis is proliferative (pro-LIFF-ruh-tiv) nephritis, which causes scars on the kidneys.
How will I know if I have lupus nephritis?
Only people who have lupus can have lupus nephritis. If you have lupus and you notice any of the following symptoms, talk to your health care provider about getting your kidney health tested.
- High blood pressure
- Foamy or bubbly urine (a sign of protein in your urine)
- Swelling in your legs, feet, ankles and sometimes your hands and face
If your health care provider thinks that your lupus might be affecting your kidneys, he or she might ask you to have urine tests to look for blood or protein in your urine. Having blood or protein in your urine can be a sign that your kidneys are not working as well as they should. Your health care provider might also want you to have a blood test to check for the amount of creatinine in your blood. Having too much creatinine in your blood is also a sign that there’s a problem with your kidneys.
If your blood and urine tests show that there might be a problem, your health care provider might want you to have a kidney biopsy to look for signs of lupus nephritis. A kidney biopsy is a test to look at a tiny piece of your kidney under a powerful microscope. During the biopsy, a needle is inserted into your kidney to collect a very small sample of your kidney tissue. A doctor will look at the sample using a microscope to check for lupus nephritis.
What is the treatment for lupus nephritis?
The treatment for lupus nephritis focuses on preventing more damage to your kidneys. Finding and treating lupus nephritis early can help prevent serious damage. Lupus damages your kidneys by causing your immune system to attack them. To prevent this from happening, your health care provider might want you to take a medicine called an immune suppressant. This type of medicine weakens your immune system so that it can’t harm your kidneys as much.
Your health care provider might also want you to take a medicine to lower your blood pressure. High blood pressure is the second most common cause of kidney failure (end-stage renal disease, or ESRD). Two common types of blood pressure medicine are ACE (angiotensin converting enzyme) inhibitors and ARBs (angiotensin receptor blockers).
Having too much fluid in your body can also raise your blood pressure and strain your heart. If your body is holding on to too much water and your feet and ankles are swelling, your health care provider might tell you to take a diuretic, also known as a water pill. This medicine can help your body get rid of some of the extra fluid it is holding on to.
What are the complications of lupus nephritis?
Lupus nephritis can cause permanent kidney damage, which is called chronic kidney disease, or CKD. The most serious type of lupus nephritis, proliferative nephritis, can cause scars to form in the kidneys. These scars damage the kidneys and keep them from working the way they should. Chronic kidney disease that gets worse and causes the kidneys to stop working is called kidney failure or end-stage renal disease (ESRD). Between 1 and 3 out of every 10 people with lupus nephritis eventually get kidney failure/ESRD.
People with lupus nephritis also have a higher chance of getting certain types of cancer, heart problems and blood vessel problems.
Where can I get information about lupus?
The Lupus Foundation of America has information about lupus here: www.lupus.org. Or you can call 1.800.558.0121.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases has information about lupus here: http://www.niams.nih.gov/Health_Info/Lupus/default.asp