The studies showed that approximately one third of patients with systemic lupus erythematosus may develop a kidney disease called lupus nephritis or lupus nephritis glomerulonephritis.Lupus often show very few signs. It does not cause pain or burning when urinating and abdominal pain also does not produce or back.The first symptom, the patient with lupus nephritis typically experience swelling in the legs, ankles or fingers. This is due to loss of protein in urine canlead to fluid retention with weight gain and swelling.
Sometimes the fact that a patient has lupus nephritis was found only after urine studies are performed. It 's very likely that if there were another urine test, urine anomalies to disappear. However, there are patients in whom abnormal findings in urine tests may persist or worsen over time. These patients require further study to determine the best treatment for disease control, because it seemsthe risk of loss of renal function.
Importantly, patients with lupus may experience some symptoms that are confused and think they have lupus nephritis. For example, urinary tract infections burning during urination or drugs used to treat lupus may produce signals that can start the confusion.There some evidence that can be done to discover if a patient has lupus nephritis.
A urinalysis is the most used and simple test to do. Aurine sample is studied to see if there are proteins and blood cells that are not normally found in urine samples urine.If no red blood cells, white blood cells, calcium (in the urinary excretion of protein or cells the blood that accumulates in the kidney tubules), or if it is discovered the presence of proteins, the possibility of lupus nephritis, and necessary.Sometimes more evidence, it was a collection of urine over a period of 24 hours measurecapacity 'kidneys filtering waste products.
Studies on the blood also can be made, and can include urea and serum creatinine. These are the tests performed to determine whether the waste is properly removed from the kidney and do not accumulate in blood.By measure serum albumin, is possible to determine whether there is a low level of protein in the blood and chemical studies such as serum sodium, potassium, bicarbonate, and determine theimbalances of salt and water in blood.There can also do blood tests to determine whether abnormalities of the immune system.
An ultrasound or IVP can be done to determine the size and shape of the kidneys. Usually, this test takes place before a renal biopsy renal biopsy.The carried out to confirm the diagnosis of lupus nephritis. Is done by inserting a needle through the skin of the back and remove a small sample of kidney.Then,the small amount taken from the kidney were examined under a microscope to determine how much inflammation or permanent damage is present in the kidney.
There are four common types of nephritis: focal or diffuse proliferative nephritis, mesangial nephritis and membranous nephropathy.
The treatment for this disease should be individualized because some patients have different needs. It is important that all factors that appear to betreatment.General account in the determination of the principles of medical management of renal disease include antihypertensive drugs to control high blood pressure, diuretics to remove excess fluid, changes in diet to control your salt intake, protein and calories. These are very important in lupus nephritis.
Corticosteroids are often used to treat lupus nephritis. We mention here prednisolone prednisone and methylprednisolone. There are still someQuestions unanswered the question of how corticosteroids work and how they can be used more effectively. As usual, high doses of corticosteroids are indicated until you see the improvement of lupus nephritis. Therefore, the dose is reduced, but not a careful observation by the doctor to make sure that nephritis is not worse.If corticosteroids administered for prolonged periods, there may be side effects such as bruising, increased 'appetite and fluid retention with weight gain, cataracts,thinning hair, increased risk of infection, diabetes and others.
When patients do not respond to treatment with corticosteroids, cytotoxic or immunosuppressive drugs are administered as azathioprine or cyclophosphamide. The effect of these drugs block the function of the immune system system.As a result, further damage to the kidneys is prevented. However, although these drugs may be useful, but can also lead to serious complications.
Although it is not appropriatetreatment, patients who develop a progressive loss of renal function and kidney failure. This requires the use of artificial dialysis and can be done with hemodialysis or peritoneal dialysis.Also, you can do a kidney transplant, and we know that this has been very successful in patients with renal lupus nephritis.
Over the years, advanced science in understanding the causes of lupus nephritis, and there have been improvements in treatmentpatients.
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