Lupus nephritis (patient information)
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Lupus nephritis |
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Lupus nephritis On the Web |
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Overview
Lupus nephritis is an inflammation of the kidney caused by systemic lupus erythematosus (SLE), which is a disease of the immune system. The underlying cause of this autoimmune disease is not clear. Usual symptoms of lupus nephritis include blood in the urine, foamy appearance to urine, hypertension, swelling and weight gain. Positive anti-nuclear antibody (ANA) titer and damaged renal function suggest the diagnosis of lupus nephritis. Treatment opinion includes medications such as corticosteroids, immunosuppressants and cytotoxic drugs. For end stage renal failure, dialysis and kidney transplant may be considered. Prognosis varies from person to person, mainly depending on the class of lupus nephritis.
What are the symptoms of Lupus nephritis?
Some patients may show no signs and symptoms of lupus nephritis. Usual symptoms include:
- Blood in the urine
- Foamy appearance to urine
- Hypertension
- Swelling of any area of the body, especially around the eyes.
- Weight gain
Diseases with similar symptoms are
What causes Lupus nephritis?
Systemic lupus erythematosus (SLE, or lupus) is an autoimmune disease. This means there is a problem with the body's immune system.
Normally, the immune system helps protect the body from harmful substances. But in patients with an autoimmune disease, the immune system cannot tell the difference between harmful substances and healthy ones. As a result, the immune system attacks otherwise healthy cells and tissue.
SLE may damage different parts of the kidney, leading to interstitial nephritis, nephrotic syndrome, andmembranous GN. It may reapidly worsen to kidney failure.
Lupus nephritis affects approximately 3 out of every 10,000 people. In children with SLE, about half will have some form or degree of kidney involvement.
More than half of patients have not had other symptoms of SLE when they are diagnosed with lupus nephritis.
SLE is most common in women ages 20 - 40.
Who is at highest risk?
The underlying cause of this autoimmune disease is not clear.
When to seek urgent medical care?
Call your doctor if your symptoms of lupus nephritis develop. If you experience the following symptoms, seeking urgent medical care as soon as possible:
- Urine output decreases even anuria.
Diagnosis
A physical exam shows signs of decreased kidney functioning with edema. Blood pressure may be high. Abnormal sounds may be heard when the doctor listens to the heart and lungs, indicating fluid overload.
Tests that may be done include:
- ANA titer.
- BUN and creatinine.
- Lupus test.
- Urinalysis.
- Urine immunoglobulin light chain
A kidney biopsy is not used to diagnose lupus nephritis, but to determine what treatment is appropriate.
This disease may also affect the results of the following tests:
- Complement component 3.
- Complement.
- Syphilis test.
Where to find medical care for Lupus nephritis?
Directions to Hospitals Treating Lupus nephritis
What to expect (Outlook/Prognosis)?
The outcome varies, depending on:
- The class of lupus nephritis: Focal lupus nephritis, minimal mesangial lupus nephritis and mesangial proliferative lupus nephritis have better prognosis than other classes. And, advanced sclerosis lupus nephritis carries a poor prognosis.
- Nephrotic syndrome carries worse prognosis.
- Creatinine level: Patients with elevated creatinine (>3 mg/dL) at presentation have worse outcomes.
- Patients with persistently elevated anti-dsDNA and low C3 and C4 levels have poorer outcomes.
- Renal biopsy findings showing diffuse lupus nephritis or high chronicity index suggest worse prognosis.
- Age onset of lupus nephritis: Young age onset carries worse prognosis.
- Male gender have poorer outcomes than female.
- Black race have worse outcomes than other races.
Possible complications
Prevention
Prevention of lupus nephritis is unknown.
Sources
http://kidney.niddk.nih.gov/kudiseases/pubs/lupusnephritis/
http://www.nlm.nih.gov/medlineplus/ency/article/000481.htm