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Lupus Nephritis: Symptoms

Posted on March 04, 2021
Medically reviewed by
Walead Latif, D.O.
Article written by
Amanda Agazio, Ph.D.

  • The symptoms of lupus nephritis are associated with the kidney damage that occurs during the disease.
  • Symptoms like foamy urine and blood in the urine may indicate an issue with your kidneys.
  • A doctor may detect signs of lupus nephritis disease activity with blood and urine tests, blood pressure monitoring, and in some cases, a kidney biopsy.

Lupus nephritis is a kidney condition that causes symptoms like foamy urine, blood in the urine, and swelling of the legs, hands, or face. Lupus nephritis is caused by the autoimmune disease systemic lupus erythematosus (SLE), or lupus. Lupus occurs when the immune system attacks the body and its tissues, which can lead to kidney damage. This affects the function of the kidneys, which are important for filtering waste and excess fluid out of the blood and into the urine.

Symptoms of Lupus Nephritis

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 the damage caused to the kidney and the glomeruli.

Foamy Urine

The urine can appear foamy in people with lupus nephritis due to excess protein in the urine. 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.

Blood in the Urine

When the urine is a light brown or pink color, this may mean it contains blood. This condition is referred to as hematuria. Blood can leak into the urine when the glomeruli are damaged.

Swelling in the Legs, Hands, and Face

Besides removing waste from the blood, kidneys also remove excess fluid from the body. When the kidneys are damaged, fluid can accumulate in places like the legs, ankles, hands, and face. Swelling can also appear around the eyes. This accumulation of excess fluid is commonly referred to as edema.

Weight Gain

People with lupus nephritis may gain weight because they are retaining fluid.

Frequent Urination

Frequent urination, especially during the night, is another common symptom of lupus nephritis. Peeing more often than usual may be an indication that the kidneys are not working properly.

Signs of Lupus Nephritis a Doctor May Notice

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.

High Levels of Creatinine in the Blood

If a doctor runs a blood test on someone with lupus and detects high levels of creatinine in the blood, this could be an indication of 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.

High Blood Pressure

The kidneys play a role in controlling blood pressure. Damage to the kidneys during lupus nephritis can affect the ability of the kidneys to regulate blood pressure and lead to high blood pressure.

Damage Detected by Kidney Biopsy

If a doctor suspects you have lupus nephritis, they may want to perform a kidney biopsy. This involves taking a very small piece of tissue from the kidney and examining it under the microscope. This procedure is performed under light sedation or general anesthesia, often in a hospital or outpatient center.

Signs of Lupus Nephritis Progression

There are six stages or classes of lupus nephritis. As the disease worsens, the stages progress. A doctor can identify lupus nephritis stages based on a kidney biopsy and a person’s kidney function.

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 ESRD. People with ESRD generally require dialysis or a kidney transplant.

The following symptoms of signs of CKD and ESRD may indicate a person’s kidney function is getting worse:

  • Shortness of breath
  • Fatigue
  • Difficulty falling and staying asleep
  • Itchy skin
  • Headaches
  • Muscle cramps
  • Nausea
  • Erectile dysfunction

A doctor may also be able to tell that lupus nephritis is getting worse by running tests on the blood and urine. They 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 progression of the disease 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.

When To Call Your Doctor

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 are getting worse. This 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. A major complication of kidney disease is heart failure, as well as 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.

Connect With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 187,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Are you living with lupus nephritis? Share your experience in the comments below, or start a conversation by posting on your Activities page.

References

  1. The Pathogenesis of Lupus Nephritis — Journal of the American Society of Nephrology
  2. How Your Kidneys Work — National Kidney Foundation
  3. Understanding Glomerular Diseases — National Kidney Foundation
  4. Lupus and Kidney Disease (Lupus Nephritis) — National Kidney Foundation
  5. Protein in Urine — American Kidney Fund
  6. Lupus Nephritis — Mayo Clinic
  7. Lupus Nephritis — American Kidney Fund
  8. End-Stage Renal Disease — Mayo Clinic
  9. Lupus and Kidney Disease (Lupus Nephritis) — National Institute of Diabetes and Digestive and Kidney Diseases
  10. Chronic Kidney Disease — NHS
Walead Latif, D.O. specializes in dialysis access management as an interventional nephrologist. Review provided by VeriMed Healthcare Network . Learn more about him here.
Amanda Agazio, Ph.D. completed her doctorate in immunology at the University of Colorado Anschutz Medical Campus. Her studies focused on the antibody response and autoimmunity. Learn more about her here.

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