Summary about Disease
Lupus nephritis is an inflammation of the kidneys caused by systemic lupus erythematosus (SLE), an autoimmune disease. SLE can affect many different organs in the body, including the skin, joints, and kidneys. When lupus affects the kidneys, it's called lupus nephritis. This inflammation can impair the kidneys' ability to filter waste products from the blood, potentially leading to kidney damage and even kidney failure.
Symptoms
Symptoms of lupus nephritis can vary widely from person to person and may develop gradually or suddenly. Some common symptoms include:
Proteinuria (protein in the urine)
Hematuria (blood in the urine)
Edema (swelling) in the legs, ankles, feet, or face
High blood pressure
Weight gain
Fatigue
Foamy urine
More frequent urination, particularly at night
Causes
Lupus nephritis is caused by systemic lupus erythematosus (SLE). In SLE, the immune system mistakenly attacks the body's own tissues and organs, including the kidneys. This attack leads to inflammation in the kidneys' filtering units (glomeruli), causing them to become damaged and less efficient. The exact reason why the immune system malfunctions in SLE is unknown, but genetic predisposition, environmental factors, and hormones are thought to play a role.
Medicine Used
Treatment for lupus nephritis typically involves a combination of medications to reduce inflammation, suppress the immune system, and control blood pressure. Common medications used include:
Immunosuppressants: Such as Cyclophosphamide, Mycophenolate mofetil (CellCept), Azathioprine (Imuran). These drugs help to suppress the overactive immune system.
Corticosteroids: Such as Prednisone. These are powerful anti-inflammatory drugs used to quickly reduce inflammation.
ACE inhibitors or ARBs: Used to control high blood pressure and reduce protein loss in the urine.
Belimumab (Benlysta): A biologic drug that targets a specific protein involved in the immune system.
Voclosporin (Lupkynis): An immunosuppressant specifically approved for lupus nephritis.
Other immunosuppressants Calcineurin inhibitors such as tacrolimus.
Is Communicable
Lupus nephritis is not communicable. It is an autoimmune disease, meaning it is not caused by an infectious agent and cannot be spread from person to person.
Precautions
While lupus nephritis itself isn't contagious, managing the condition and minimizing kidney damage requires several precautions:
Follow your doctor's treatment plan: Adhere to prescribed medications and dosages.
Regular monitoring: Attend all scheduled appointments for blood and urine tests to monitor kidney function and disease activity.
Healthy lifestyle: Maintain a healthy diet, exercise regularly, and get enough rest.
Avoid smoking: Smoking can worsen lupus and kidney disease.
Limit sun exposure: Sunlight can trigger lupus flares. Wear protective clothing and use sunscreen.
Manage stress: Stress can also trigger flares. Practice relaxation techniques such as yoga or meditation.
Prevent infections: Infections can be more severe in people with lupus. Get vaccinated against the flu and pneumonia.
Inform healthcare providers: Tell all your healthcare providers about your lupus nephritis and the medications you are taking.
How long does an outbreak last?
The duration of a lupus nephritis "outbreak" or flare can vary greatly from person to person. Flares can last for weeks, months, or even longer. Some people may experience frequent flares, while others may have long periods of remission with few or no flares. The length of a flare can be influenced by factors such as treatment adherence, overall health, and exposure to triggers.
How is it diagnosed?
Lupus nephritis is diagnosed through a combination of:
Medical history and physical exam: The doctor will ask about your symptoms, medical history, and family history.
Urine tests: To detect protein and blood in the urine. A 24-hour urine collection may be done to measure the amount of protein in the urine.
Blood tests: To assess kidney function, measure levels of certain antibodies (such as anti-dsDNA and anti-Sm antibodies), and evaluate overall immune system activity.
Kidney biopsy: A small sample of kidney tissue is removed and examined under a microscope to confirm the diagnosis, determine the extent of kidney damage, and guide treatment decisions.
Imaging tests: Such as ultrasound or CT scan, may be used to assess the size and structure of the kidneys.
Timeline of Symptoms
The timeline of lupus nephritis symptoms can vary. Some individuals may experience a rapid onset of symptoms over days or weeks, while others have a more gradual development over months or years. Early symptoms may be subtle, such as mild swelling or fatigue, and can be easily overlooked. As kidney damage progresses, more noticeable symptoms such as significant swelling, high blood pressure, and changes in urination may appear. Flares can occur at any time, with periods of increased disease activity followed by periods of remission.
Important Considerations
Early diagnosis and treatment: Early diagnosis and treatment are crucial to prevent or slow down kidney damage.
Individualized treatment: Treatment plans should be tailored to the individual's specific needs and disease severity.
Long-term management: Lupus nephritis is a chronic condition that requires ongoing monitoring and management.
Potential complications: Possible complications include kidney failure, high blood pressure, and increased risk of infection.
Pregnancy: Women with lupus nephritis should discuss family planning with their doctor, as pregnancy can increase the risk of complications.
Support: Support groups and counseling can help people cope with the emotional and practical challenges of living with lupus nephritis.