Lupus nephritis is a common associated condition that is primarily noticed in people suffering from lupus erythematosus causing inflammation of the kidneys. Lupus erythematosus a.k.a Lupus is an autoimmune malady which turns your immune system against itself by producing proteins called autoantibodies that damage your tissues and organs, including the kidneys. In addition to the kidneys, lupus can also damage the joints, skin, brain, heart, and other parts of your body.
Lupus nephritis chiefly occurs when the autoantibodies arising due to lupus affect structures in the kidneys that are employed to filter out waste from the body. This induces inflammation of the kidneys and may lead to blood and protein in the urine, high blood pressure, imbalance of salts, acids and minerals in the body fluids, hormonal imbalance steering towards degraded kidney function, kidney failure and even end-stage renal disease.
Also Read: Cutaneous Lupus Erythematosus: Causes, Symptoms, Diagnosis And Treatment
Causes
As many as half the population with systemic lupus erythematosus develops lupus nephritis with time. This condition causes the immune system proteins to harm the kidneys, damaging their ability to filter out waste. Long-term inflammation of the kidneys leads to scarring and permanent kidney damage.
Risk Factors
Certain causative factors that increase the risk of Lupus nephritis:
Age: Lupus nephritis is commonly diagnosed in people between the ages of 15 and 44
Gender: The incidence of men getting this inflammatory condition is more than women
Ethnicity: People of black, native American descent or Hispanic/Latino or Pacific Islander or Asian descent are more at risk of Lupus nephritis
Exposure To Substances: People who come in contact with viruses, certain infections, toxic chemicals, carcinogens or suspended pollutants in the environment are at an aggravated risk of getting Lupus nephritis
Heredity: A person who has a family history of the disease or any other autoimmune disease is at a higher risk of Lupus nephritis
Symptoms
The symptoms of lupus nephritis often take about five years to cultivate after the initial diagnosis of lupus. But sometimes, lupus nephritis can be the first or the only indication of systemic lupus erythematosus. The common signs and symptoms of Lupus nephritis include:
- Edema in your lower body or around the eyes
- Hematuria (blood in the urine)
- High blood pressure
- Increased urination
- Pain or inflammation in the joints
- Swelling around the joints
- Fever
- Pain or inflammation in the joints
- Swelling around the joints
- Muscular pain
- Proteinuria (protein in the urine)
- Weight gain (due to accumulation of excess fluid in your body)
- Red rash on the face
Diagnosis And Treatment
If you notice any of the above-mentioned manifestations of Lupus nephritis, do consult a doctor at the earliest to get diagnosed right away. The doctor usually does a thorough physical examination, studies the symptoms and analyzes the medical history. He or she may also perform certain diagnostic procedures including:
- Antibody blood tests look for high levels of proteins created by the body's immune system
- Urine protein test to look for the presence of protein in the urine
- Urinalysis to inspect the urine for wastes and other unusual substances
- Kidney function tests
- Kidney biopsy to discern the severity of the kidney damage
Treatment
Although there is no absolute cure for lupus nephritis, the treatment plan primarily aims to diminish the symptoms or make them disappear, lower their chances of remission, prevent the condition from aggravating and averting the need for dialysis or a kidney transplant. These available treatment options include:
Blood pressure medications: Medications like Angiotensin II receptor blockers (ARBs) and Angiotensin-converting-enzyme inhibitors (ACE inhibitors) to help regulate blood pressure and curtail protein loss
Corticosteroids and immunosuppressive drugs: Medications to impede your innate immunity from damaging the blood vessels in the kidneys
Dietary modification: Opt for a diet with less sodium (salt). Consuming less protein, such as meat and dairy, can also make it easier for the kidneys to function better. Consult your healthcare provider and dietitian to get a customised diet plan depending on your needs
Diuretics: Medications to help deal with edema (accumulation of excess fluid and swelling in the body) and lower blood pressure
In case of Kidney failure which occurs in 10% to 30% of people suffering from lupus nephritis, the doctor usually suggests the following course of treatment:
Dialysis: A procedure to clean the blood routinely when the kidneys aren’t working properly
Kidney transplant: A surgical technique that replaces one of the damaged kidneys with a healthy kidney from a donor.
