How Lupus Affects the Kidneys: Understanding Lupus Nephritis

Lupus is a chronic autoimmune disease in which the immune system mistakenly attacks the body’s tissues. The most common type of lupus is systemic lupus erythematosus (SLE). One of the most severe complications of SLE is a condition known as lupus nephritis. This occurs when the immune system creates autoantibodies that pinpoint the kidneys. Inflammation makes it difficult for the kidneys to filter through blood and regulate bodily fluids and electrolytes. This can lead to permanent kidney damage or even failure if it is left untreated.

*Disclaimer:

The information provided in this article is for general informational purposes only and is not intended as medical advice. It should not be used as a substitute for professional diagnosis, treatment, or advice from a qualified healthcare provider. Reliance on any information provided in this article is solely at your own risk.

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Currently, there are 6 classes of lupus nephritis based on severity:

• Minimal Mesangial (Class 1)

• Mesangial Proliferative (Class 2)

• Focal Proliferative (Class 3)

• Diffuse Proliferative (Class 4)

• Membranous (Class 5)

• Advanced Sclerosis (Class 6)

Some symptoms of lupus nephritis include: foamy urine, swelling in the legs, ankles, or the eyes, high blood pressure, and frequent urination. Many people with lupus nephritis typically do not notice symptoms early on, which is why there is emphasis on getting tested.

Some of the tests that can help diagnose lupus nephritis include:

• Urinalysis to check for blood and proteins in the urine

• Kidney biopsies to help figure out what type and class of lupus nephritis you may have​

• Immunological tests to detect specific lupus antibodies, like ANA, and anti-dsDNA

While there is no cure for lupus nephritis, there are several treatments that can help slow its progress and reduce symptoms. These treatments aim to reduce the amount of inflammation in the kidneys, preserve the kidneys’ functions, and prevent future flare-ups. Some common treatments are:

• Corticosteroids like prednisone (this reduces the inflammation)

• Biologics like belimumab and rituximab

• Immunosuppressants like mycophenolate, mofetil, and cyclophosphamide

• ACE Inhibitors to control levels of blood pressure and proteinuria

Up to 30% of people with lupus nephritis may develop end stage kidney disease (ESKD) which requires dialysis or a kidney transplant.

It is important to:

• Visit a rheumatologist and nephrologist

• Follow diets recommended by your doctor

• Follow medications prescribed by your physician

• Minimize stress to prevent flare ups

With early detection and treatment, people with lupus nephritis can live a long, normal life.

Living with lupus nephritis can be difficult but not impossible. By keeping up with your regular doctor appointments and taking the right medication, lupus nephritis can be managed effectively.

Lupus Nephritis | Mayo Clinic

Lupus and Kidney Disease (Lupus Nephritis) | NIDKK

Lupus Nephritis | National Kidney Foundation