Lupus
Lupus: Support and Survival

Lupus Nephritis


Lupus nephritis is an inflammation of the kidney caused by systemic lupus erythematosus (SLE), a disease of the immune system. SLE causes harm to the skin, joints, kidneys, and brain. Lupus Nephritis is characterized by damage to the glomerulus and progressive loss of kidney function.

Lupus often causes nephrotic syndrome (excessive protein excretion) and may progress rapidly to renal failure. There is progressive azotemia (the accumulation of nitrogenous waste products in the blood stream) and urinary abnormalities including protein and blood in the urine.

Some people with SLE may have no symptoms of kidney disease. However, lupus nephritis may cause weight gain, high blood pressure, dark urine, or swelling around the eyes, legs, ankles, or fingers.

Prevention:
There is no known prevention for lupus nephritis.

Symptoms:
• blood in the urine
• foamy appearance to urine
• swelling of any area of the body
• elevated blood pressure

Signs that begin a diagnosis of Lupus nephritis:
Examination of patient indicates decreased kidney functioning with edema (swelling of body tissue) and may indicate renal failure.

Tests:
• Abnormal urinalysis with protein, casts, and red blood cells present in the urine.
• ANA titer is high.
• Syphilis tests may be falsely positive.
• BUN and creatinine may be used to assess kidney functioning.
• A lupus erythematosus (LE) cell test is positive.
• A Kidney biopsy is indicated, not to diagnose lupus nephritis, but to determine what treatment is appropriate for the renal component of SLE.
• A urine immunoglobulin light chain is elevated.

Treatment:
Treatment depends on the symptoms. Medicines can decrease swelling, lower blood pressure, and decrease inflammation by suppressing the immune system. Patients may need to limit protein, sodium, and potassium intake in their diet.

Corticosteroids or other immunosuppressive medications are often effective in reducing symptoms.

Dialysis may be necessary to control symptoms of acute or chronic renal failure. Renal failure may be severe enough to require dialysis even if no other symptoms of SLE are present.

A kidney transplant may be recommended to treat kidney failure resulting from lupus nephritis.

Complications:
• acute renal failure
• chronic renal failure
• end-stage renal disease
• nephrotic syndrome

Prognosis:
The outcome varies. It is usually worse with diffuse proliferative lupus nephritis (one specific form of the disorder). The course of treatment is varied following acute episodes and remissions (symptom free periods).

Some cases of lupus nephritis may progress to chronic renal failure.

Over 80% of people with lupus nephritis severe enough to require dialysis or transplantation will survive for more than 5 years after treatment. Although lupus nephritis may recur in a transplanted kidney, it rarely leads to end stage renal disease. People with active lupus should not undergo transplantation.


Contact the Lupus Foundation of America or the local Chapter that serves your area for more information about lupus, or the programs and services the LFA offers including support group information and physician referral.

Lupus Foundation of America., Inc.
1300 Piccard Drive, Suite 200
Rockville, MD 20850-4303
301-670-9292  800-558-0121
http://www.lupus.org

Information gathered from:
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
National Institutes of Health
Yahoo Health and A.D.A.M., Inc.
 


Searching for ways to deal with the depression, the frustrations, the questions about lupus, I joined a support group online.  LUPIES has been a wonderful gift.  I have learned more from the information I found on the support web site from other sufferers of Lupus than I did from my doctor.
Thank you fellow Lupies!    May your days be pain free!

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