Learn about this common lupus complication affecting the kidneys, including symptoms to watch for, how it's diagnosed and what treatments are available.
Lupus nephritis is a frequent complication in people who have systemic lupus erythematosus — more commonly known as lupus.
Lupus is an autoimmune disease. It causes your immune system to produce proteins called autoantibodies that attack your own tissues and organs, including the kidneys.
Lupus nephritis occurs when lupus autoantibodies affect structures in your kidneys that filter out waste. This causes kidney inflammation and may lead to blood in the urine, protein in the urine, high blood pressure, impaired kidney function or even kidney failure.
The kidneys remove waste and excess fluid from your blood through filtering units called nephrons. Each nephron contains a filter (glomerulus) that has a network of tiny blood vessels called capillaries. When blood flows into a glomerulus, tiny molecules — water, essential minerals and nutrients, and wastes — pass through the capillary walls. Large molecules, such as proteins and red blood cells, do not. The filtered solution then passes into another part of the nephron called the tubule. The water, nutrients and minerals your body needs are transferred back to the bloodstream. The excess water and waste become urine that flows to the bladder.
Signs and symptoms of lupus nephritis include:
As many as half of adults with systemic lupus develop lupus nephritis. Systemic lupus causes immune system proteins to damage the kidneys, harming their ability to filter out waste.
There aren't a lot of known risk factors for lupus nephritis, except for:
Lupus nephritis can lead to worsened kidney function or kidney failure.
Tests to diagnose lupus nephritis include:
There's no cure for lupus nephritis. Treatment aims to:
In general, doctors may recommend these treatments for people with kidney disease:
However, conservative treatment alone isn't effective for lupus nephritis.
For severe lupus nephritis, you might take medications that slow or stop the immune system from attacking healthy cells, such as:
Clinical trials may also be available for new therapies. Determining what medications might help you requires a careful discussion of the benefits and risks with your doctor.
For people who progress to kidney failure, treatment options include: