Lupus nephritis is a kidney disorder which is a complication of systemic lupus erythematosus.
Nephritis - lupus; Lupus glomerular disease
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 infection or harmful substances. But in people 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 tissues.
SLE may damage different parts of the kidney. This can lead lead to disorders such as interstitial nephritis, nephrotic syndrome, and membranous glomerulonephritis. Over time, kidney failure can result.
Symptoms of lupus nephritis include:
Exams and Tests
A physical exam shows signs of decreased kidney functioning with body swelling (edema). Blood pressure may be high. Abnormal sounds may be heard when the doctor listens to your heart and lungs.
Tests that may be done include:
- ANA titer
- BUN and creatinine
- Complement levels
- Urine protein
- Kidney biopsy, to determine appropriate treatment
The goal of treatment is to improve kidney function and to delay kidney failure.
Medicines may include drugs that suppress the immune system, such as corticosteroids, cyclophosphamide, mycophenolate mofetil, or azathioprine.
You may need dialysis to control symptoms of kidney failure, sometimes for only a while. A kidney transplant may be recommended. People with active lupus should not have a transplant because the condition can occur in the transplanted kidney.
How well you do, depends on the specific form of lupus nephritis. You may have flare-ups, and then times when you do not have any symptoms.
Some people with this condition develop chronic kidney failure.
Although lupus nephritis may return in a transplanted kidney, it rarely leads to end-stage kidney disease.
Complications that may result from lupus nephritis include:
When to Contact a Medical Professional
If you have lupus nephritis, call your provider if you notice decreased urine output.
Treating lupus may help prevent or delay onset of lupus nephritis.
Appel GB, Jayne D, Rovin BH. Lupus nephritis. In: Johnson RJ, Feehally J, Floege J, eds. Comprehensive Clinical Nephrology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 26.
Hahn BH, McMahon M, Wilkinson A, et al. American College of Rheumatology Guidelines for Screening, Case Definition, Treatment and Management of Lupus Nephritis. Arthritis Care Res (Hoboken). 2012;64(6):797-808. PMC:3437757 www.ncbi.nlm.nih.gov/pmc/articles/PMC3437757.