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Kidney Biopsy came back with class III and class V lupus nephritis. It's not about the diagnosis for me...

A MyLupusTeam Member asked a question 💭
Houston, TX

My question for those with lupus nephritis is what treatment plan should I be discussing with my doctor if my kidneys aren't failing or damaged? What labs should I ask the doctors to monitor to see how treatment is properly working? Will the treatment keep my kidneys healthy or can things progress?

It's so many questions I have because I'm not a diagnosis and medication girlie. I am a resourceful let's partner and figure out how to get things in remission and at a base line. I also want to know… read more

July 15
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A MyLupusTeam Member

@A MyLupusTeam Member omg my endocrinologist wants me to do a 24 hour urine collection so she can check and do something with my calcium, I hate doing a 24 hour urine collection because it is a pain lol...

July 17
MyLupusTeam

That analytical energy is exactly what helps people become great advocates for their own health — so let's break this down piece by piece!

Treatment Plan to Discuss With Your Doctor

Classes III and V together typically call for more aggressive treatment. Here's what to bring up:

- Immunosuppressive medications to calm the Show Full Answer

That analytical energy is exactly what helps people become great advocates for their own health — so let's break this down piece by piece!

Treatment Plan to Discuss With Your Doctor

Classes III and V together typically call for more aggressive treatment. Here's what to bring up:

- Immunosuppressive medications to calm the immune system and reduce kidney inflammation
- Corticosteroids to help manage active inflammation
- Blood pressure medications (even if BP seems okay) to protect kidney function
- Lifestyle adjustments like reducing sodium, limiting saturated fats, and cutting back on alcohol

The goal is exactly what's been described — getting to remission and maintaining a stable baseline. Labs to Ask Your Doctor to Monitor

These are the key markers to track how well treatment is working:

- Urine protein levels — excess protein in urine signals kidney stress
- Urine blood tests — checking for blood that shouldn't be there
- Creatinine blood levels — high creatinine means kidneys aren't filtering waste properly
- Overall kidney function panels — regular blood work to track trends over time

Asking for consistent, scheduled monitoring of these gives a clear picture of whether treatment is holding the line. Can Things Progress Even With Treatment?

Honestly, yes — but treatment significantly reduces that risk. Between 10–30% of people with lupus nephritis can progress to more serious kidney disease if left unmanaged. The good news is that early, consistent treatment can slow or even stop progression. Staying on top of those labs is the best early warning system. What Other Organs Could Be Affected?

Lupus is a whole-body condition, so it's smart to think ahead. Beyond the kidneys, lupus can affect:

- Joints — causing swelling, stiffness, and pain (especially fingers, wrists, knees)
- Cardiovascular system — heart and blood vessels can be impacted
- Blood and lymph nodes
- Nervous system
- Musculoskeletal system

Regular check-ins with your rheumatologist help keep an eye on all of these, not just the kidneys. The partnership mindset with your care team — rheumatologist AND nephrologist working together — is genuinely the best approach here. Bring your questions, bring this list, and don't leave appointments without a clear monitoring plan. You've got this.

July 15
A MyLupusTeam Member

The other rarely used test is a 24-hour urine collection, but in the past 20 years or so, it's become apparent that the urine protein/creatinine ratio is very sensitive and much easier than the 24-hour collection! I used to do that in the old days, and it's a pain.😂

July 17 (edited)
A MyLupusTeam Member

@A MyLupusTeam Member I love your upfront transparency!! Currently I'm only taking benlysta and I had a kenalog IM shot about a month ago, I've been experiencing joint pain again, I just am tired of taking steroids they made me gain so much weight... My nephrologist wants me to see Rheumatologist to discuss treatment plan, I see him next Thursday..

Thank you for sharing the tests, I'll keep these in mind and make sure my doctors stay on top of things.

You and @A MyLupusTeam Member make me have hope you know, I just want everything to go in remission soon... I'll definitely keep you all posted on things. Thank you for your help and support 🙏🏾💜

July 16
A MyLupusTeam Member

@A MyLupusTeam Member thank you for sharing this with me, when you were first diagnosed were things really bad in your kidneys and have you had to change your medication? I absolutely need my nephrologist and Rheumatologist to work together in every way, I want to keep things on a calm pathway as much as possible. I just at 40 didn't think I would be experiencing all of this. Thank you for sharing that article, it's resourceful... Looking forward to learning more...

July 16

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