Do you or someone you know have lupus? Then you've probably heard that this disease can affect many parts of the body. In addition to the skin and joints, lupus can also affect the kidneys, which are very important organs in our body. Today we are going to talk about the effects of lupus on the kidneys, a condition called Lupus Nephritis. Don't worry, let's talk about this simply.
Simply put, what is Lupus Nephritis?
Okay, first let's understand what Lupus is. Lupus is an autoimmune disease . That is, the immune system, which protects our body from disease, mistakenly starts attacking our own healthy tissues and organs. It's like our own army attacking our own country. The most common type of lupus is Systemic Lupus Erythematosus (SLE) .
Now, when our immune system attacks our kidneys in this way, it causes inflammation, that is, swelling, and damage to the kidneys. That is the condition we call Lupus Nephritis .
The kidneys are like the two filters in our body. If they don't work properly, big problems can arise. Lupus Nephritis can cause the kidneys to not be able to do the following things properly:
- Filtering and removing waste products from the blood.
- Maintaining the body's fluid levels, salts, acids, and minerals at the proper levels.
- Controlling blood pressure and blood volume.
- Regulating hormone levels.
If this condition is not managed properly, it can eventually lead to kidney failure and even end-stage renal disease, requiring lifelong treatment. Therefore, it is very important to be aware of this.
Who is most likely to develop this condition?
To develop Lupus Nephritis, a person must first have lupus (SLE). Let's take a look at who is at higher risk of developing lupus:
- For women: Nine out of ten people with lupus are women. The risk is especially high for those between the ages of 15 and 44. But surprisingly, if a man develops lupus, they are more likely to develop Lupus Nephritis.
- Heredity: If someone in the family has lupus, others are also at risk.
- Genetic influence: This disease is more common in people of Asian, African, and Native American descent.
- Environmental factors: It is believed that exposure to certain viruses, infections, and toxic chemicals may also cause this.
- Other autoimmune diseases: If a person already has another autoimmune disease, the risk of developing lupus may be slightly increased.
About 50% of adults with lupus, or about one in two, may develop lupus nephritis. About 80% of children with lupus, or about four in five, may develop this kidney disease.
What could be the symptoms of this?
Lupus Nephritis symptoms usually appear about five years after the onset of lupus symptoms. However, sometimes, the first and only symptom of lupus can be the kidney damage. It is important to be aware of these symptoms.
Imagine your legs, especially your ankles, are swollen. Or when you wake up in the morning, your eyes feel puffy. Your urine is more foamy than usual. These are often the first signs you notice.
Let's look at these symptoms clearly.
| Symptom | Simple explanation |
|---|---|
| Swelling (Edema) | Swelling in the legs, ankles, feet, or around the eyes due to fluid accumulation in the body. |
| Protein in the urine (Proteinuria) | The urine becomes foamy (like soap suds) due to the release of protein in the urine. |
| Blood in the urine (Hematuria) | A small amount of blood in the urine. It may not be visible to the naked eye, but the urine may be pink or dark brown in color. |
| High Blood Pressure | Increased blood pressure due to impaired kidney function. |
| Weight gain | Sudden weight gain due to fluid accumulation in the body. |
| Other lupus symptoms | Joint pain or swelling, muscle aches, unexplained fever, and a red, butterfly-shaped rash on the face. |
How does a doctor find this?
If you have these symptoms, your doctor will first examine you, ask about your symptoms and medical history, and then order several tests to confirm the diagnosis.
- Blood Tests:
- Antibody blood tests: These check for elevated levels of certain proteins (antibodies) produced by the immune system. These are more common in lupus.
- Kidney function tests: Measures things like creatinine to see how well the kidneys are functioning.
- Urine Tests:
- Urinalysis: Checks the urine for blood, protein, or other abnormalities.
- Urine protein test: Measures exactly how much protein is in the urine.
- Kidney Biopsy:
This is the best way to definitively diagnose Lupus Nephritis and determine the extent of kidney damage. A very small piece of tissue is taken from the kidney using a fine needle and examined under a microscope. This is usually done in a hospital setting, under light anesthesia.
What are the treatments for this?
There are two main goals of treating lupus nephritis. One is to control symptoms. The other is to stop or slow down further damage to the kidneys. Treatment usually involves medications and dietary changes.
| Treatment method | What happens to it? |
|---|---|
| Immunosuppressive drugs | These medications work by controlling the immune system's ability to attack our own kidneys. Corticosteroids are the most commonly used medication for this purpose. |
| Blood pressure medications | Medications like ACE inhibitors and ARBs control blood pressure and reduce protein excretion in the urine, which can reduce damage to the kidneys. |
| Diuretics | These are also called 'water pills'. They help reduce swelling by eliminating excess fluid from the body as urine. They also help lower blood pressure. |
| Changes in diet | Your doctor may advise you to reduce the strain on your kidneys and reduce your sodium intake . You may also be asked to limit high-protein foods like meat and dairy. It's best to talk to your doctor and a nutritionist about this and come up with a diet plan that's right for you. |
Does everyone have to undergo dialysis?
No. It doesn't happen to everyone. Between 10% and 30% of people with Lupus Nephritis eventually develop kidney failure. If that happens, you may need to consider these treatments:
- Dialysis: The process of filtering waste products from the blood using a machine when the kidneys are not working properly.
- Kidney Transplant: Surgical replacement of a failing kidney with a healthy kidney.
When do you need to see a doctor urgently?
If you have lupus, be aware of any changes in your kidneys. If one or more of the following symptoms appear suddenly, it could be a sign of sudden kidney failure . If this happens, you should seek medical advice immediately . If necessary, go to the Emergency Department (ETU) of the nearest hospital.
- Stomach ache
- Difficulty urinating, or a very small amount of urine being passed
- Excessive fatigue or drowsiness
- Foamy or bloody urine
- Itchy skin
- Sudden increase in blood pressure
- Appetite
- Nausea and vomiting
- Difficulty breathing
- Body swelling
Living with this condition can be challenging, but with proper treatment and medical advice, many people have been able to live a normal life. The most important thing is to maintain regular contact with your doctor and get all the tests and treatments you need.
Take-Home Message
- Lupus Nephritis is kidney damage and inflammation caused by lupus (SLE).
- Swelling of the legs, swelling around the eyes, foamy urine, and high blood pressure may be the main symptoms related to this .
- Early diagnosis and treatment of this disease can greatly reduce the damage to the kidneys.
- Treatment includes immunosuppressive medications, blood pressure medications, and dietary changes.
- It is very important to follow your doctor's instructions exactly and attend clinics on time.
- If emergency symptoms occur, seek medical advice immediately.
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