What is Lupus Nephritis?
What is Lupus Nephritis? Lupus nephritis is an inflammation of the kidneys that results from the disease of systemic lupus erythematosus (SLE) or better known as lupus. Lupus is an autoimmune disease in which the immune system attacks healthy tissues.
Lupus nephritis is one of the most serious complications of lupus. It is estimated that about 60 percent of people with lupus develop lupus nephritis. This condition will interfere with kidney function as a filter of waste substances in the body. As a result, blood and protein will fail to filter in the kidneys and may appear in the urine. Impaired renal function in the long term will increase the risk of kidney failure.
If a person has renal failure, they should undergo a periodic dialysis or hemodialysis process. This procedure is done by filtration machine. A person with lupus nephritis sometimes needs to have a kidney transplant if the condition is very severe.
Symptoms of Lupus Nephritis
The symptoms of lupus nephritis are not much different from other kidney disorders. Symptoms consist of:
- The appearance of blood in the urine.
- Urine is foamy and dark.
- Frequent urination, especially at night.
- High blood pressure.
- Weight gain.
- Swelling in the palms, calves, and / or ankles.
Diagnosis of Lupus Nephritis
To diagnose lupus nephritis, the doctor will ask for a medical history of the patient, then perform a physical examination and evaluation of symptoms experienced by the patient. Doctors may also perform a series of tests that include:
- Blood test. This test will help the doctor in seeing the content of zar-waste substances in the blood, for example creatinine and urea in the blood. Under normal conditions, these substances should not appear because they have been filtered by the kidneys.
- Urine examination. Urine examination aims to measure kidney function. This check will identify the levels of protein, red blood cells, and white blood cells.
- 24 hour urine examination. This method is performed to measure the ability of the kidney in filtering out waste substances in the body. This examination will show how much protein content appears in the urine within 24 hours.
- Ultrasound. Ultrasound examination is performed by using waves to display the kidney condition in detail. From this examination, the doctor will be able to see any abnormalities in the shape and size of the kidney.
- Kidney biopsy. Biopsy is the most accurate examination to diagnose kidney disorders. The doctor will insert the needle into the kidney through the abdomen, take a sample of kidney tissue, then
- Iothalamate clearance. Radioactive substances called iothalamate will be injected into the blood, then the doctor will see how quickly the substance gets into the urine. This test will show whether the kidneys are still functioning properly.
After making the diagnosis, the doctor can ascertain how severe the damage to the patient’s kidney. The World Health Organization (WHO) divides lupus nephritis into five stages:
- Stage 1. At this stage, doctors do not find any signs of lupus nephritis.
- Stage 2. At this stage, mild lupus nephritis may heal only with corticosteroids.
- Stage 3. At this stage, lupus nephritis has entered the alert level. This condition can be treated with high doses of corticosteroids.
- Stage 4. If already entering this stage, lupus nephritis can cause kidney failure. Doctors will give high doses of corticosteroids and drugs to control the immune system.
- Stage 5. Lupus nephritis gets worse when it enters this stage. Patients will experience large amounts of protein loss and swelling in some parts of the body.
Treatment of Lupus Nephritis
Treatment of lupus nephritis will be tailored to the type or stage of lupus nephritis experienced. Broadly speaking, lupus nephritis can be overcome by:
- Corticosteroid drugs. Anti-inflammatory drugs of this type can help reduce inflammation. The doctor may give corticosteroids until the patient’s condition improves. These drugs can cause harmful side effects. Therefore, the doctor will monitor the patient very carefully.
- Immunosuppressant drugs. This type of drug is often used to treat cancer or prevent rejection of organ transplant procedures. This drug will inhibit immune activity that damages the kidneys.
- Other drugs, to prevent blood clots or low blood pressure if needed.
The most severe complication of lupus nephritis is renal failure. Patients with renal failure should:
- Hemodialysis or dialysis. This method is used to replace kidney function in filtering impurities in the body, maintain the balance of mineral content in the blood, and control blood pressure.
- Kidney transplant. This procedure will be recommended in patients whose kidneys are no longer functioning. Kidney patients will be replaced with healthy kidneys obtained from donors.
Prevention of Lupus Nephritis
Applying a healthy lifestyle can protect yourself from kidney disorders, including lupus nephritis. Some steps that can be done are:
- Exercise regularly.
- Eating lots of mineral water.
- Do not smoke and consume alcohol.
- Keep blood pressure in order to stay normal.
- Limit levels of cholesterol in the blood.
- Reduce foods that contain lots of salt.
- Avoid the use of drugs that can affect the kidneys, one of which is non-teroid anti-inflammatory drugs (NSAIDs).