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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.
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.
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.
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.
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 more often than usual may be 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 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.
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.
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.
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:
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.
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.
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