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Management of lupus nephritis: Symptoms and causes

The systemic lupus erythematosus (SLE) is commonly called lupus. Lupus is an “autoimmune” condition, meaning the immune system (the body’s defense mechanism), which normally protects the body from disease, turns against the body. This causes damage to organs and tissues. Lupus nephritis is one of the most serious complications of lupus. It occurs when SLE causes your immune system to attack your kidneys — specifically, the parts of your kidney that filter your blood for waste products. People with lupus nephritis may even need a kidney transplant.

What are the symptoms of lupus nephritis?

  • Blood in the urine (hematuria): Glomerular disease can cause your glomeruli to leak blood into your urine. Your urine may look pink or light brown from the blood.
  • Protein in the urine (proteinuria): Glomerular disease can cause your glomeruli to leak protein into your urine. Your urine may be foamy because of the protein.
  • Edema: Having extra fluid that your kidneys cannot remove that causes swelling in body parts like your legs, ankles, or around your eyes.
  • Having to urinate often, especially at night.
  • Weight Gain
  • High blood pressure

What are the causes of lupus nephritis?

No one knows what causes the disease. Your family history and stuff in your environments such as infections, viruses, toxic chemicals or contaminants (car fumes, factory smoke) can play a role in causing the disease. Men and women of all ages and races get lupus. However, about 90 percent of people diagnosed with lupus are women.

Testing for lupus nephritis

One of the first signs of lupus nephritis is blood in your urine or extremely foamy urine. High blood pressure and swelling in your feet also might indicate lupus nephritis. Your doctor will do a physical examination, get your medical history, and do special tests. These tests include blood tests,  urine tests, kidney biopsy, Iothalamate clearance testing, and ultrasounds. 

Treatment options for lupus nephritis

There’s no treatment for lupus nephritis. The aim of treatment is to prevent the issue from getting worse. Stopping kidney damage early will eliminate the need for a kidney transplant. Lupus is treated with medications that block the body’s immune system. That include medications like steroids (corticosteroid) and antimalarial drugs. Everyone is different and the doctor will make a care plan that is appropriate for you. Typically treatment for lupus nephritis include:

  • Corticosteroids (often called “steroids”)
  • Immunosuppressive drugs
  • ACE inhibitors and ARBs
  • Diuretics
  • Diet change
  • minimizing your intake of protein and salt
  • taking blood pressure medication
  • using steroids such as prednisone (Rayos) to reduce swelling and inflammation
  • taking medicines to suppress your immune system such as cyclophosphamide or mycophenolate-mofetil (CellCept)

Most patients perform well long-term. You will need to take medications for several years. And patients who have fewer flare-ups or symptoms should have routine checkups. If you have more severe nephritis symptoms, you’re at greater risk for a loss of kidney function. Treatments can be used to slow the course of nephritis, but they aren’t always effective. Speak to your doctor about which medication is right for you.

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