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Lupus Nephritis: Symptoms And Treatments

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Lupus can be a difficult, damaging illness to live with at the best of times, and lupus sufferers should also strive to keep their condition under control as much as is faesibly possible. However, no lupus treatment is 100% effective. It's important that lupus sufferers, as well as people who know and care for them, are aware of the damage it can cause, and what steps should be taken to treat this damage.

One of the most common parts of the body affected by lupus is the urinary system, particularly the kidneys. Over time, damage to the kidneys and their associated organs and tissues can lead to a serious and dangerous condition known as lupus nephritis.

What is lupus nephritis?

Put simply, lupus nephritis occurs when the waste produce filters within the kidneys, known as nephrons, become inflamed and damaged as the body's immune system attacks its own organs and tissues. This inflammation drastically reduces the efficiency and filtering capacity of the affected kidney(s), and can also affect the release of hormones that the kidneys release to control vital bodily functions, such as blood pressure and red blood cell production.

What are the symptoms of lupus nephritis?

In some cases, the first stages of lupus nephritis can be mostly or entirely asymptomatic -- for this reason (amongst many others) it's important that lupus sufferers have their urine tested regularly by a registered urologist, as well as having their blood chemistry tested. However, in most cases, lupus nephritis will cause one or more of the following symptoms to manifest:

  • Swelling - Visible swelling of the skin and subcutaneous tissues is a common symptom of lupus nephritis, and usually affects the ankles, legs, hands and eyes. Swelling can appear in other places, however.
  • Weight gain - This is generally caused by increased fluid retention within the fat cells.
  • High blood pressure
  • Urinary tract problems - This may be something as simple as slightly dark or foamy urine, or as complex and painful as a full-blown urinary tract infection. Urination may also become more frequent, especially at night.

How can lupus nephritis be treated?

The first step of any course of treatment for lupus nephritis is a thorough examination of the kidneys and related tissues by a urologist -- this may require a kidney biopsy, but while this procedure is sometimes painful, it is minimally invasive, and usually heals quickly.

If lupus nephritis is diagnosed, the urologist will recommend a course of treatment based on the patients needs, the severity of the inflammation, and what treatments the patient is capable of enduring. The following treatments are usually prescribed for lupus nephritis sufferers:

  • Immunosuppressive medications - Suppressing the parts of the immune system that are causing the kidney damage is generally the first step of lupus nephritis treatment, and various immunosuppresants, such as azathioprine, mycophenolate and cyclophosphamide can be prescribed. 
  • Corticosteroids - These powerful steroids are usually injected directly into the kidneys through the skin, and reduce inflammation quickly and effectively. However, long term use of corticosteroids comes with a range of potential (and often serious) side effects, so these treatments will only be administered when necessary.
  • Blood pressure medications - These are administered in cases where lupus nephritis has caused high blood pressure, and reduces the risk of hypertension and blood clots.
  • Specialised diet - Reducing the amounts of protein, sodium and potassium in your diet reduces the strain on the affected kidney's nephrons, and can promote faster healing.

In most cases, lupus nephritis goes into a remission with proper treatment -- however, in some cases nephritis progresses despite all medical treatment, and the affected kidney may begin to fail. In these cases, it may be necessary to start dialysis treatment, or even receive a kidney transplant -- these are serious, life-changing treatments, so be sure to discuss the matter thoroughly with your urologist if it comes to that.