Lupus nephritis (patient information)
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What is lupus nephritis?
How do I know if I have lupus nephritis and what are the symptoms of lupus nephritis?
Some patients may show no signs and symptoms of lupus nephritis. Usual symptoms include:
- Blood in the urine
- Foamy appearance to urine
- Hypertension
- Swelling of any area of the body, especially around the eyes.
- Weight gain
Who is at risk for lupus nephritis?
The underlying cause of this autoimmune disease is not clear.
How to know you have lupus nephritis ?
- Urinalysis: Patients with lupus nephritis may demonstrate blood or protein in the urine which is a sign of kidney damage.
- Anti-nuclear antibody (ANA) titer: Anti-nuclear antibody titer was the first indication that processes affecting the cell nucleus were responsible for systemic lupus erythematosus (SLE) and is used to measure the pattern and amount of autoantibody. In patients with lupus nephritis, it is higher than normal.
- Blood tests: Patients with lupus nephritis may demonstrate elevated BUN and creatinine. These are damages of kidney function.
- Kidney images such as x-ray, ultrasound and CT: These images can show the shape and size of the surfaces of the kidney, and tell the stucture of the kidney. They may help doctor exclude other diseases in the kidney.
- Kidney biopsy: This biopsy can confirm the diagnosis of lupus nephritis and determine how far the damages have developed. During this procedure, the doctor insert a long needle through the skin to obtain a kidney tissue sample for examination with a microscope. And more important, the result of biopsy can help select appropriate treatment for patients.
When to seek urgent medical care?
Call your doctor if your symptoms of lupus nephritis develop. If you experience the following symptoms, seeking urgent medical care as soon as possible:
- Urine output decreases even anuria.
Treatment options
Treatment of lupus nephritis depends on the symptoms and test results. The purpose of treatment is to improve kidney function.
- General treatments
- Take a kidney disease diet, limiting protein, sodium, and potassium in your diet.
- Maintain your weight
- Have a bedrest
- Avoid nephrotoxicity drugs
- Control blood pressure
- Medicines
- Corticosteroids: Corticosteroids can decrease swelling and inflammation by suppressing the immune system. Side effects of corticosteroids may include a decreased ability against infection, worse healing in the wound and osteoporosis.
- Immunosuppressants: Immunosuppressive drugs, such as cyclophosphamide, mycophenolate mofetil, or azathioprine, may be used if the patient has an inadequate response or excessive sensitivity to corticosteroids.
- Cytotoxic drugs: These kind of drugs may interfere with growth of normal and neoplastic cells by cross-linking of DNA or RNA or proteins and are typically given to people who have lupus nephritis to prevent kidney damage. Usual drugs include cyclophosphamide and azathioprine. Side effects include marrow suppression, liver damage, nausea and vomiting.
- Dialysis: When you develop end stage renal failure, the doctor may recommend dialysis. There are two types of dialysis, hemodialysis and peritoneal dialysis.
- Kidney transplant: This is an operation that places a healthy kidney to take over the work of the two kidneys that failed. Some transplanted kidneys come from donors who have died and, while others come from a living family member. Patients who have transplants need to take immunosuppressants to keep their body from rejecting the new kidney for the rest of their lives.
Diseases with similar symptoms
Where to find medical care for lupus nephritis?
Directions to Hospitals Treating lupus nephritis
Prevention of lupus nephritis
Prevention of lupus nephritis is unknown.
What to expect (Outlook/Prognosis)?
The outcome varies, depending on:
- The class of lupus nephritis: Focal lupus nephritis, minimal mesangial lupus nephritis and mesangial proliferative lupus nephritis have better prognosis than other classes. And, advanced sclerosis lupus nephritis carries a poor prognosis.
- Nephrotic syndrome carries worse prognosis.
- Creatinine level: Patients with elevated creatinine (>3 mg/dL) at presentation have worse outcomes.
- Patients with persistently elevated anti-dsDNA and low C3 and C4 levels have poorer outcomes.
- Renal biopsy findings showing diffuse lupus nephritis or high chronicity index suggest worse prognosis.
- Age onset of lupus nephritis: Young age onset carries worse prognosis.
- Male gender have poorer outcomes than female
- Black race have worse outcomes than other races
Copyleft Sources
http://kidney.niddk.nih.gov/kudiseases/pubs/lupusnephritis/
http://www.nlm.nih.gov/medlineplus/ency/article/000481.htm
http://www.umm.edu/ency/article/000481.htm
http://emedicine.medscape.com/article/330369-overview
http://www.csmc.edu/Patients/Health-Conditions/Lupus-Nephritis.aspx