Lupus nephritis is inflammation of the kidney where they can't function normally, caused by Systemic Lupus Erythematous (SLE) attacking its own tissues. Left untreated it can lead to kidney failure and is one of the more severe features of SLE. Up to 60% of SLE patients can develop this complication.
The symptoms vary widely between patients and there are often no symptoms at all. One symptom may be sudden swelling – of the legs/ankles or feet and sometimes face or hands (the kidneys are unable to remove the extra water in the blood of the patient). Other symptoms include: weight gain, high blood pressure, dark urine, foamy frothing urine, blood in the urine, pain in your mid back and increased urination during the night.
It is important to detect kidney disease early since treatment can prevent permanent damage. Lupus patients who have high levels of antibodies especially anti-DNA antibodies and low levels of blood protein complement are more likely to develop kidney inflammation. Such patients should have regular checking of their blood pressure and have urine dip tests for blood and protein.
A kidney biopsy may be performed which involves taking a small piece of kidney tissue to examine under a microscope. This is the best way to diagnose kidney inflammation and plan immuno suppressing treatment.
Patients with kidney involvement should be closely monitored by a kidney specialist. Although treatment with steroids and immuno suppressing treatments like Mycophenolate are very successful, often aspects such as blood pressure need careful monitoring and treatment.
Not all kidney problems are due to lupus nephritis. Lupus patients are prone to urinary tract infections, these usually manifest as burning when urinating, the need to urinate frequently, sometimes feeling feverish and unwell and are usually treated with a course of antibiotics.
Changes in lifestyle can help protect your kidneys. Keeping hydrated by drinking plenty of water - especially when the weather is warm or you are exercising, stop smoking, avoid alcohol, exercise regularly (click here for our article on exercise), maintain a healthy blood pressure and eat a low sodium diet as that helps if you do have high blood pressure. If you have diabetes keep your blood sugar well controlled, reduce high cholesterol levels and avoid medications that can affect the kidneys (NSAIDs such as ibuprofen and high dose aspirin).