What Is Lupus Nephritis? Symptoms & Treatment

What Is Lupus Nephritis
Lupus is a chronic autoimmune disease that causes the immune system to mistakenly attack its own tissues and organs. When lupus affects the kidneys, it is called lupus nephritis.

Lupus is a chronic autoimmune disease that causes the immune system to mistakenly attack its own tissues and organs, causing inflammation and pain, commonly in the skin, joints, kidneys, and brain. 

When lupus affects the kidneys, it is called lupus nephritis.

What Are Symptoms of Lupus Nephritis?

Symptoms of lupus nephritis may include symptoms that are similar to lupus as well as:

  • Protein in urine (proteinuria)
    • Urine may be foamy, bubbly, or frothy
  • Blood in the urine (hematuria)
    • Urine may appear pink or light brown
  • Fluid retention (edema
    • Swelling in the legs, ankles, or around the eyes
  • High blood pressure (hypertension)
  • Weight gain
  • Kidney problems
    • Joint pain or swelling
    • Fever with no known cause
    • Muscle pain
    • Red rash, often on the face, across the nose and cheeks (called a “butterfly rash” due to its shape)

How Is Lupus Nephritis Diagnosed?

If a person has been diagnosed with lupus, lupus nephritis can be diagnosed with medical  history and physical examination, and tests such as:

  • Urine test to check for protein and blood
  • Blood tests
    • Antiphospholipid antibodies  
    • Protein levels
    • Cholesterol
    • Glomerular filtration rate (GFR) which shows how well the kidneys filter waste
    • Antinuclear antibodies (ANA) 
  • Kidney biopsy 

What Is the Treatment for Lupus Nephritis?

Lupus nephritis is treated by treating lupus as well as the kidney symptoms of lupus nephritis. 

  • Corticosteroids, such as prednisone
  • Immunosuppressive drugs, such as cyclophosphamide (Cytoxan) or mycophenolate mofetil (CellCept)
  • Blood pressure medications
    • Angiotensin converting enzyme (ACE) inhibitors 
    • Angiotensin receptor blockers (ARBs)
    • Beta-blockers
    • Calcium channel blockers
    • Diuretics
    • Other blood pressure medications
  • Antimalarials such as hydroxychloroquine (Plaquenil)
  • Some chemotherapy drugs
  • Diet changes
    • Reducing salt (sodium) 
    • Reducing protein 

Home treatment that may help patients manage symptoms of lupus include:

  • Sun protection 
  • Dietary modifications
    • Some patients may need increased calories
    • Daily multivitamin 
    • Vitamin D supplementation
    • Salt restriction in patients with high blood pressure (hypertension) and/or kidney inflammation (nephritis)
  • Smoking cessation
  • Vaccination as recommended by your doctor
  • Physical activity
  • Manage other medical conditions such as high blood pressure or osteoporosis
References
Image Source:

https://www.kidney.org/atoz/content/lupus

https://www.allinforlupusnephritis.com/about-lupus-nephritis/signs-and-symptoms

https://www.niddk.nih.gov/health-information/kidney-disease/lupus-nephritis

https://www.lupus.org/

https://www.uptodate.com/contents/epidemiology-and-pathogenesis-of-systemic-lupus-erythematosus?search=What%20Causes%20Lupus%3F&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H7

https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-systemic-lupus-erythematosus-in-adults?search=Lupus&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H2215760526

https://www.cdc.gov/lupus/basics/women.htm