Lupus nephritis arises when systemic lupus erythematosus, which is an autoimmune disease, affects the kidneys, causing inflammation and damage to the small vessels responsible for filtering toxins from the body. Thus, the kidney is no longer able to function normally and symptoms such as blood in the urine, high blood pressure or constant pain in the joints, for example, appear.
This disease affects more than half of lupus patients and is more common in women in their third decade of life, although it can also affect men and people and other ages, being one of the main causes of death from lupus.
Although it is a serious complication of lupus, nephritis can be controlled with the proper treatment and, therefore, it is very important that people who suffer from lupus have regular consultations and examinations to assess the presence of complications. When not treated properly, lupus nephritis can lead to kidney failure.
The symptoms of lupus nephritis can vary greatly from person to person, however, the most common are:
- Blood in urine;
- Urine with foam;
- Excessive swelling of legs, feet, face or hands;
- Constant pain in joints and muscles;
- Increased blood pressure;
- Fever without apparent cause;
When you have lupus and one or more of these symptoms appear, it is very important to consult the doctor who is treating the disease, so that he can perform tests such as a urine test or blood test and confirm the presence, or not, of nephritis, starting treatment.
In some cases, it may even be necessary to take a kidney biopsy to confirm the diagnosis. For this, the doctor applies anesthesia at the site and, using a needle, removes a piece of tissue from the kidney, which is then analyzed in the laboratory. Renal biopsy should be performed in all patients with lupus, as well as in those with abnormal test results, such as increased creatinine, decreased glomerular filtration, and the presence of protein and blood in the urine.
Renal ultrasound is a first-line imaging study in the assessment of patients with manifestations of a kidney disease, as it allows for the identification of alterations such as obstructions and also allows the assessment of the organ’s anatomy.
How is the treatment done
Treatment for lupus nephritis usually starts with the use of prescription drugs to slow the immune system’s response and reduce inflammation in the kidneys. Some of these drugs are steroids, such as prednisone and immunosuppressants. Combined treatment is more effective than that using only steroids.
In addition, depending on the symptoms, it may be necessary to use diuretics to lower blood pressure and to remove excess toxins and fluids from the body.
In some cases it may also be recommended to consult a nutritionist to change the diet in order to facilitate the kidney’s work and reduce the progression of lupus.
In more severe cases, in which lupus has caused a lot of damage to the kidney, renal failure may begin and, therefore, treatment may involve the use of hemodialysis or even kidney transplantation.
Classification and types of lupus nephritis
Lupus nephritis can be divided into 6 classes. In Class I and II there are very mild changes in the kidney, which may not cause symptoms or cause mild signs, such as bloody urine or the presence of proteins in the urine test.
From Class III, lesions affect an increasingly larger area of the glomeruli, being increasingly severe, leading to decreased kidney function. The class of lupus nephritis is always identified after performing diagnostic tests to help the doctor decide the best form of treatment for each case. In addition, the doctor will also need to consider the person’s age and general medical condition.