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Lupus nephritis

Nephritis - lupus; Lupus glomerular disease

 

Lupus nephritis is a kidney disorder which is a complication of systemic lupus erythematosus .

Causes

 

Systemic lupus erythematosus (SLE or lupus) is an autoimmune disease . This means there is a problem with the body's immune system.

Normally, the immune system helps protect the body from infection or harmful substances. But in people with an autoimmune disease, the immune system cannot tell the difference between harmful substances and healthy ones. As a result, the immune system attacks otherwise healthy cells and tissues.

SLE may damage different parts of the kidney. This can lead lead to disorders such as interstitial nephritis , nephrotic syndrome , and membranous glomerulonephritis . Over time, kidney failure can result.

 

Symptoms

 

Symptoms of lupus nephritis include:

  • Blood in the urine
  • Foamy appearance to urine
  • High blood pressure
  • Swelling of any area of the body

 

Exams and Tests

 

A physical exam shows signs of decreased kidney functioning with body swelling (edema). Blood pressure may be high. Abnormal sounds may be heard when the doctor listens to your heart and lungs.

Tests that may be done include:

  • ANA titer
  • BUN and creatinine
  • Complement levels
  • Urinalysis
  • Urine protein
  • Kidney biopsy , to determine appropriate treatment

 

Treatment

 

The goal of treatment is to improve kidney function and to delay kidney failure.

Medicines may include drugs that suppress the immune system, such as corticosteroids, cyclophosphamide, mycophenolate mofetil, or azathioprine.

You may need dialysis to control symptoms of kidney failure, sometimes for only a while. A kidney transplant may be recommended. People with active lupus should not have a transplant because the condition can occur in the transplanted kidney.

 

Outlook (Prognosis)

 

How well you do, depends on the specific form of lupus nephritis. You may have flare-ups, and then times when you do not have any symptoms.

Some people with this condition develop chronic kidney failure.

Although lupus nephritis may return in a transplanted kidney, it rarely leads to end-stage kidney disease.

 

Possible Complications

 

Complications that may result from lupus nephritis include:

  • Acute renal failure
  • Chronic renal failure

 

When to Contact a Medical Professional

 

Call your health care provider if you have blood in the urine or swelling of your body.

If you have lupus nephritis, call your provider if you notice decreased urine output .

 

Prevention

 

Treating lupus may help prevent or delay onset of lupus nephritis.

 

 

Open References

References

Appel GB, Jayne D, Rovin BH. Lupus nephritis. In: Johnson RJ, Feehally J, Floege J, eds. Comprehensive Clinical Nephrology . 5th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 26.

Hahn BH, McMahon M, Wilkinson A, et al. American College of Rheumatology Guidelines for Screening, Case Definition, Treatment and Management of Lupus Nephritis. Arthritis Care Res (Hoboken) . 2012;64(6):797-808. PMC:3437757 www.ncbi.nlm.nih.gov/pmc/articles/PMC3437757 .

 
  • Male urinary system

    Male urinary system - illustration

    The urinary system is made up of the kidneys, ureters, urethra and bladder.

    Male urinary system

    illustration

    • Male urinary system

      Male urinary system - illustration

      The urinary system is made up of the kidneys, ureters, urethra and bladder.

      Male urinary system

      illustration

    A Closer Look

     

      Tests for Lupus nephritis

       
         

        Review Date: 9/22/2015

        Reviewed By: Charles Silberberg, DO, private practice specializing in nephrology, affiliated with New York Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

        The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

         
         
         

         

         

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