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    Lupus nephritis

    Nephritis - lupus; Lupus glomerular disease

    Lupus nephritis is a kidney disorder that is a complication of systemic lupus erythematosus.

    Causes

    Systemic lupus erythematosus (SLE, or lupus) is an autoimmune disease. This means there is a problem with the body's immune system.

    Normally, the immune system helps protect the body from infection or harmful substances. But in patients with an autoimmune disease, the immune system cannot tell the difference between harmful substances and healthy ones. As a result, the immune system attacks otherwise healthy cells and tissue.

    SLE may damage different parts of the kidney, leading to interstitial nephritis, nephrotic syndrome, and membranous GN. It may rapidly worsen to kidney failure.

    Lupus nephritis affects approximately 3 out of every 10,000 people. In children with SLE, about half will have some form or degree of kidney involvement.

    More than half of patients have not had other symptoms of SLE when they are diagnosed with lupus nephritis.

    SLE is most common in women ages 20 - 40. For more information, see: systemic lupus erythematosus.

    Symptoms

    Symptoms of lupus nephritis include:

    • Blood in the urine
    • Foamy appearance to urine
    • High blood pressure
    • Swelling of any area of the body

    For general lupus symptoms, see the article on SLE.

    Exams and Tests

    A physical exam shows signs of decreased kidney functioning with body swelling (edema). Blood pressure may be high. Abnormal sounds may be heard when the doctor listens to your heart and lungs.

    Tests that may be done include:

    • ANA titer
    • BUN and creatinine
    • Complement levels
    • Urinalysis
    • Urine protein

    This list may not be all-inclusive.

    A kidney biopsy is not used to diagnose lupus nephritis, but to determine what treatment is appropriate.

    Treatment

    The goal of treatment is to improve kidney function and to delay kidney failure.

    Medicines may include corticosteroids or other medications that suppress the immune system, such as cyclophosphamide, mycophenolate mofetil, or azathioprine.

    You may need dialysis to control symptoms of kidney failure, sometimes for only a while. A kidney transplant may be recommended. People with active lupus should not have a transplant because the condition can occur in the transplanted kidney.

    Outlook (Prognosis)

    How well you do depends on the specific form of lupus nephritis. You may have flare-ups, and then times when you do not have any symptoms.

    Some people with this condition develop chronic kidney failure.

    Although lupus nephritis may return in a transplanted kidney, it rarely leads to end-stage kidney disease.

    • Acute renal failure
    • Chronic renal failure
    • End-stage renal disease
    • Nephrotic syndrome

    When to Contact a Medical Professional

    Call your health care provider if you have blood in the urine or swelling of your body.

    If you have lupus nephritis, call your health care provider if you notice decreased urine output.

    Prevention

    There is no known prevention for lupus nephritis.

    References

    Appel GB. Glomerular disorders and nephrotic syndromes. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 122.

    Appel GB, Radhakrishnan J, D'Agati V. Secondary glomerular disease. In: Brenner BM, ed. Brenner and Rector's the Kidney. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 31.

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          Tests for Lupus nephritis

            Review Date: 9/8/2013

            Reviewed By: Charles Silberberg, DO, Private Practice specializing in Nephrology, Affiliated with New York Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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