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Systemic lupus erythematosus (SLE), most commonly referred to as “lupus”, is a condition in which the immune system attacks various areas of the body. Lepus nephritis is one of the most severe complications of lupus. Lupus nephritis occurs when SLE causes the immune system to attack the kidneys, specifically the parts of the kidneys used to filter waste products from the blood. Statistics show that up to 60 percent of lupus patients will develop lupus nephritis. Without prompt treatment, lupus nephritis can result in kidney failure.
Lupus Nephritis Symptoms
Symptoms associated with lupus nephritis are generally not serious at first. One of the most noticeable symptoms that patients often experience is swelling of the legs, feet and ankles. In some instances, patients may experience swelling of the hands or face. Symptoms vary from patient to patient, but may include high blood pressure, weight gain, dark urine, frequent urination, and frothy or foamy urine. It’s important to note; however, that not all kidney or urinary problems stem from lupus or lupus nephritis. Certain lupus medications can mimic the symptoms of lupus nephritis and will go away when the drugs are no longer used.
Testing for Lupus Nephritis
Diagnosing lupus can be challenging, as many of the symptoms are shared with other similar conditions. One of the first signs of lupus nephritis is extremely foamy urine or blood in the urine. Tests that can help diagnosis lupus nephritis include blood and urine tests. Blood is tested to look for elevated levels of waste products, such as urea and creatinine, which would normally be filtered out by the kidneys. A 24-hour urine collection may also be used to measure the kidney’s ability to filter out wastes, and to detect the amount of protein in the urine over a 24 hour period.
In some cases, an iothalamate clearance test may be administered to see if the kidneys are filtering correctly. Using a contrast dye, radioactive iothalamate is injected into the bloodstream to examine how quickly it is excreted back into the urine. Other diagnostic tests include a kidney biopsy, which is the most accurate way to test for kidney disease. A biopsy is performed by inserting a long needle through the stomach and into the kidney, where a sample is then taken. An ultrasound may also be used as a diagnostic tool to create a detailed image of the kidney.
Treatment for Lupus Nephritis
There are five different types of lupus nephritis and treatment is generally based on the type the patient has. Medications that may be prescribed to help treat the condition include corticosteroids and immunosuppressive drugs. In some cases, the patient may also be prescribed medications to prevent blood clots and to lower blood pressure. Even with treatment, kidney function loss may continue to progress. If both kidneys fail, the patient may need dialysis to properly filter waste from the blood.
It’s important for patients with lupus nephritis to make the necessary lifestyle changes to stay healthy and strong. Basic steps towards wellness include drinking enough fluids to stay well hydrated, and eating a low-sodium diet, especially when hypertension becomes a problem. Patients should also avoid drinking alcohol, smoking, and taken any illicit drugs. Regular exercise can help the patient maintain their health, and eating a balanced diet while limiting cholesterol can aid in maintaining a healthy blood pressure. It’s also important for patients with lupus nephritis to avoid medications that can directly affect the kidneys, including non-steroidal anti-inflammatory drugs (NSAIDs). While lupus nephritis remains a serious condition, the right treatment and lifestyle changes will ensure that kidney failure is prevented.