Lupus nephritis is a kidney condition that causes symptoms like foamy urine, blood in the urine, and swelling of the legs, hands, or face. It’s caused by the autoimmune disease systemic lupus erythematosus, often simply called lupus. Lupus occurs when a person’s immune system attacks their body and its tissues, which can lead to kidney damage. This damage affects important kidney function, including filtering waste and excess fluid out of the blood and into the urine.
During lupus nephritis, small blood vessels in the kidney, known as glomeruli, become damaged by the immune system. The glomeruli pull waste out of the blood and into the urine. Many symptoms of lupus nephritis are associated with damage to the kidney and the glomeruli.
The urine can appear foamy in people with lupus nephritis due to excess protein. This condition is known as proteinuria. The damage that occurs to the glomeruli during lupus nephritis can allow protein from the blood to leak into the urine.
Besides removing waste from the blood, kidneys also remove excess fluid from the body. When the kidneys are damaged, fluid can accumulate in places such as the legs, ankles, hands, and face. Swelling can also appear around the eyes. This accumulation of excess fluid is commonly referred to as edema.
People with lupus nephritis may gain weight because they are retaining fluid.
Frequent urination, especially during the night, is another common symptom of lupus nephritis. Peeing often can serve as an indication that the kidneys are not working properly.
Lupus nephritis is a common condition that occurs in up to 50 percent of people living with lupus. Your doctor should monitor you for signs of lupus nephritis. They will run tests on the urine and blood, and they may even want a biopsy of the kidney tissue. The results of these tests may indicate the presence of lupus nephritis.
If a doctor detects high levels of creatinine in the blood of someone living with lupus, it could indicate lupus nephritis. Creatinine is a natural waste product created by the breakdown of muscles in the body. Properly functioning kidneys should filter this waste out of the blood and into the urine.
If a doctor suspects you have lupus nephritis, they may want to perform a kidney biopsy. This procedure involves taking a very small piece of tissue from the kidney and examining it under a microscope. A kidney biopsy is performed under light sedation or general anesthesia, often in a hospital or outpatient center.
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Some people living with lupus nephritis will progress to chronic kidney disease (CKD). If more damage occurs and kidney function gets worse, some people may progress from CKD to end-stage renal disease (ESRD). Up to 30 percent of people with lupus nephritis will develop into ESRD. People with ESRD generally require dialysis or a kidney transplant.
The following symptoms or signs of CKD and ESRD may indicate a person’s kidney function is getting worse:
A doctor may also be able to tell that lupus nephritis is getting worse by running tests on the blood and urine. A doctor can also assess kidney damage by taking a biopsy of the kidney tissue and analyzing it under a microscope.
Fortunately, treatments for lupus and lupus nephritis can slow the disease’s progression and limit damage to the kidneys. Taking certain medications, along with living a healthy lifestyle that supports the kidneys, can benefit many people living with lupus nephritis.
You should talk to your doctor if you are experiencing any of the signs and symptoms of lupus nephritis, CKD, or ESRD. You should also talk to your doctor if you notice your symptoms of lupus nephritis getting worse, which could indicate the disease is progressing. You may require changes to your treatment plan or a different kind of therapy, such as dialysis.
People with lupus nephritis are at higher risk for heart and blood vessel problems. Heart failure is a major complication of kidney disease, as are other conditions associated with the heart. If you suspect you are experiencing the symptoms of a heart attack — including chest pain and shortness of breath — get emergency help right away.
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