Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that causes the body’s immune system to mistakenly attack its own organs and tissues, causing inflammation and pain, commonly in the skin, joints, kidneys, and brain and may be fatal. SLE that affects the kidneys is called lupus nephritis.
Lupus nephritis is treated with different types of medications, including:
- Corticosteroids, such as prednisone
- Immunosuppressive drugs, such as cyclophosphamide (Cytoxan) or mycophenolate mofetil (CellCept)
- Blood pressure medications
- Angiotensin converting enzyme (ACE) inhibitors
- Angiotensin receptor blockers (ARBs)
- Calcium channel blockers
- Other blood pressure medications
- Antimalarials such as hydroxychloroquine (Plaquenil)
- Some chemotherapy drugs
- Diet changes
- Reducing salt (sodium)
- Reducing protein
What Are Symptoms of Lupus Nephritis?
Symptoms of lupus nephritis may include:
- Blood in the urine (hematuria): urine may appear pink or light brown
- Protein in the urine (proteinuria): urine may be foamy, bubbly, or frothy
- Fluid retention (edema) that causes swelling in the legs, ankles, or around the eyes
- Weight gain
- High blood pressure (hypertension)
- Kidney problems
What Causes Lupus Nephritis?
The cause of lupus nephritis is unknown.
Factors that may play a role in developing the disease include:
- Family history
- Toxic chemicals or pollutants (car fumes, factory smoke)
How Is Lupus Nephritis Diagnosed?
In addition to a patient history and physical examination, tests used to diagnose lupus nephritis include:
- Urine test to check for protein and blood
- Blood tests
- Protein levels
- Glomerular filtration rate (GFR) which shows how well the kidneys filter waste
- Antiphospholipid antibodies
- Antinuclear antibodies (ANA)
- Kidney biopsy
What Are Complications of Lupus Nephritis?
Complications of lupus nephritis are uncommon because treatment usually works well. When complications of lupus nephritis occur, they may include:
- Kidney failure (occurs in 10 to 30 percent of patients)
- Scarring in the kidneys, which occurs with the most severe form of lupus nephritis (diffuse proliferative nephritis)
- Scars are permanent
- Kidney function declines as scars form
- Increased risk of cancer, especially B-cell lymphoma, a type of cancer that forms in cells of the immune system
- Increased risk of heart and blood vessel problems
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