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Lupus nephritis is a kidney condition that causes signs like foamy urine and blood in the urine, and symptoms like swelling in the legs, hands, or face. It’s caused by the autoimmune disease systemic lupus erythematosus (SLE), the most common type of lupus. SLE is often simply called lupus.
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About 50 percent of adults living with lupus develop lupus nephritis, so it’s important to be aware of the signs and symptoms. Learn more about the different signs you can look out for and tests your doctor may order.
Lupus develops when a person’s immune system attacks their body and its tissues, which can lead to inflammation of the kidneys or, in severe cases, kidney failure. Kidney damage affects important kidney function, including filtering waste and excess fluid out of the blood and into the urine.
In lupus nephritis, groups of small blood vessels in the kidney — known as glomeruli — become damaged by the immune system. The glomeruli filter waste out of the blood, and that waste ends up in the urine. Many symptoms of lupus nephritis are associated with kidney and glomeruli damage. Lupus nephritis symptoms usually happen alongside other lupus symptoms, such as fatigue, joint pain, and stiffness.
Below are six common signs or symptoms of lupus nephritis.
Excess protein in the urine can cause foamy urine in people with lupus nephritis. This condition is known as proteinuria. The damage that occurs to the glomeruli in lupus nephritis can allow protein from the blood to leak into the urine.
When urine is light brown or pink, it may contain blood. This condition is referred to as hematuria. Blood can leak into the urine when the glomeruli are damaged.
In addition to removing waste from the blood, the kidneys also remove excess fluid from the body. When the kidneys are damaged, fluid can build up in the legs, ankles, hands, and face, leading to swelling. Swelling can also happen around the eyes. This buildup of excess fluid is commonly referred to as edema.
People with lupus nephritis may gain or lose weight. Weight gain is more common, often due to the body holding onto extra fluid. This can happen when the kidneys don’t work as well as they should, causing fluid to build up. Additionally, weight gain is associated with lupus in general and can be a side effect of certain medications, particularly corticosteroids (steroids).
Lupus symptoms such as joint pain and fatigue can make it harder to maintain a healthy diet and stay physically active, which may lead to a less active lifestyle.
Frequent urination, especially at night, is a common symptom of lupus nephritis. It can be a sign that the kidneys aren’t working as well as they should. When the kidneys don’t function properly, fluid can build up, causing you to pass more urine. People with lupus nephritis are also at a higher risk of urinary tract infections (UTIs). UTIs often cause people to pee more frequently.
The kidneys play a role in controlling blood pressure. Kidney damage resulting from lupus nephritis can affect the organ’s ability to regulate blood pressure, leading to hypertension (high blood pressure).
Your doctor should monitor you for signs of the condition. They’ll run tests on the urine and blood, and they may even want a biopsy of the kidney tissue. The results of these tests may point to the presence of lupus nephritis.
If a doctor detects high levels of creatinine in the blood of someone with lupus, it could point to lupus nephritis. Creatinine is a natural waste product created by the breakdown of muscles. Properly functioning kidneys should filter this waste out of the blood and into the urine.
If a healthcare provider suspects you have lupus nephritis, they may want to order 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, often in a hospital or outpatient center.
There are six stages or classes of lupus nephritis. The stages progress as the disease worsens. A nephrologist (kidney doctor) can identify lupus nephritis stages based on a kidney biopsy and a person’s kidney function, signs, and symptoms.
Some people living with lupus nephritis will go on to have 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), also called kidney failure. Up to 30 percent of people with lupus nephritis will develop ESRD. People with ESRD generally require dialysis or a kidney transplant.
The following symptoms or signs of CKD and ESRD may indicate that a person’s kidney health is getting worse:
A doctor may also be able to tell that lupus nephritis is getting worse by running blood and urine tests and performing a kidney biopsy.
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.
Talk to your doctor if you’re 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 that 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, and so are other conditions associated with the heart. If you suspect you’re experiencing symptoms of a heart attack — such as chest pain and shortness of breath — get emergency help right away.
On MyLupusTeam, people share their experiences with lupus, get advice, and find support from others who understand.
If you’re living with lupus nephritis, what symptoms have you experienced? Let others know in the comments below.
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I will be 64 in June please never think that, you can take control of your life. Eat healthy, exercise in your seat, and visit your doctor regularly.
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