Lupus nephritis (also known as lupus glomerulonephritis) is the medical term given to a form of kidney disease caused by systemic lupus erythematosus (SLE). Nephritis causes protein to leak from the kidneys which is then removed from the body through urine.
When lupus nephritis is present, inflammation occurs in the kidneys and a person may experience any or all of the following symptoms:
Weight gain
High blood pressure
Foamy urine
Swelling (edema) around the feet, ankles, and legs
Fluid retention
This form of kidney disease is found in approximately 1/3 of lupus patients. Many times it is not associated with pain in the abdomen or back and may go unnoticed for long periods of time.
The first sign of lupus nephritis is often weight gain and swelling which is the result of fluid retention caused by the loss of protein in the urine. Nephritis is a potentially dangerous symptom of lupus disease because if not treated, it can lead to kidney failure.
Urinalysis is the most common way to test for lupus nephritis and is generally conducted over a 24 hour period to test if the kidneys are functioning properly. Urinalysis looks for proteins and blood cells that are not normally found in urine. If these proteins and blood cells are found in a urine sample, then it indicates kidney damage.
Blood tests can also be performed to see if the kidney is properly removing wastes from the body. These include the blood urea nitrogen (BUN) study and the serum creatinine study. Other tests like the serum albumin study and the serum sodium study can be used to test for lower blood protein levels and salt/water imbalances, respectively.
If the above tests suggest lupus nephritis is present, a kidney biopsy may be performed to confirm the diagnosis and to measure the extent of kidney damage. Treatment of lupus nephritis is done on an individual basis and may include any of the following:
Diuretic agents to reduce excess fluid
Anti-hypertensive drugs to control high blood pressure
Anticoagulation drugs to prevent complications from blood clots
Dietary changes to control salt, water, and protein balances
Corticosteroids to reduce inflammation
Immunosuppressive drugs to reduce the activity of the immune system
In severe cases, treatment may fail and dialysis or a kidney transplant may be required. However, new advancements in the treatment of lupus nephritis have greatly increased a patient's odds of living a normal life span.
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