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LUPUS NEPHRITIS 

 

Systemic lupus erythematosus (SLE) is an autoimmune disorder which occurs when the immune system attacks one’s own healthy body cells in different areas. Lupus nephritis is a serious complication of SLE which results when the kidney cells get attacked by the immune system. Nearly 60% of the patients with SLE develop lupus nephritis. In this condition the kidneys become inflamed and cannot function efficiently.

Symptoms

The first symptom which is noticed in people with lupus nephritis is the swelling or edema in the feet, legs and ankles which can worsen with days. Sometimes there can be swelling in the face and hands. The other symptoms of lupus nephritis are similar to the other kidney diseases, which may include:

  • Blood in urine
  • Dark colored urine
  • Foamy or cloudy urine
  • Weight gain
  • High blood pressure
  • Frequent urination especially at night times

Risk factors

Both men and women of any age group can develop lupus nephritis. However, it is more common in women. Additionally, the below factors can increase the risk of lupus nephritis:

  • A family history of the condition
  • Environmental factors such as toxic chemicals or pollutants
  • Infections especially caused by viruses

Diagnosis

The doctor may recommend further tests based on the above mentioned symptoms. The following are the tests performed for the diagnosis of lupus nephritis.

  • Physical examination is performed to check for abnormal heart and lung sounds.
  • Urine test helps in monitoring the levels of proteins eliminated through urine over a period of 24 hours. This gives the filtering ability of the kidneys. Urine tests are also conducted to identify the levels of red blood cells and white blood cells.
  • Blood tests help in checking the level of waste materials such as urea and creatinine which are usually elevated in kidney diseases.
  • Lothalamate clearance test is performed to measure the rate at which kidneys filter the waste materials. This is done by injecting radioactive iothalamate into the blood and the time in which it is excreted in urine is noted.
  • Imaging tests such as ultrasound is conducted to look for abnormalities in the shape and size of the kidneys.
  • Biopsy in which a sample tissue is collected from the kidneys and microscopically analyzed for the signs of damage.

Treatment

The main goal of the treatment is to delay or prevent the worsening of the condition. However, lupus nephritis cannot be completely cured. Treatment helps in relieving the symptoms and prevents the need for kidney transplant. Treatment is based on the type of lupus nephritis and the patient’s overall health. The following are the treatment options for lupus nephritis.

  • Blood pressure medicines such as calcium channel blockers or beta blockers or ACE inhibitors or ARBs are given either alone or in combinations.
  • Diuretics or water pills are given to remove excess fluid from the body.
  • Blood-thinning medications may be given to prevent the formation of blood clots.
  • Corticosteroid drugs are given to reduce inflammation. However, careful monitoring is required due to the risk of potential side effects with these drugs. Also, the dose is tapered down once the symptoms improve.
  • Immune suppressing agents may be given to prevent the immune cells from attacking the healthy kidney cells.
  • Additionally, the doctor will suggest the patient to reduce the intake of salt and proteins to reduce the work load of the kidneys.

If the kidney damage is severe, then additional treatment such as dialysis may be necessary. Dialysis is an artificial method of filtering the wastes from the body using a machine. In some patients, kidney transplant is the final option.

Complications

People with lupus nephritis have a risk of developing acute or chronic kidney failure and need dialysis or kidney transplant.

Prevention

Taking prompt treatment for SLE helps to prevent lupus nephritis.

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