Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that causes the body’s immune system to mistakenly attack its own organs and tissues, causing inflammation and pain, commonly in the skin, joints, kidneys, and brain, and may be fatal. When SLE affects the kidneys, it is called lupus nephritis.
Life expectancy for lupus nephritis depends on the severity of the symptoms and how well patients respond to medications. Treatment for lupus nephritis is very effective and about 80 to 90 percent of people with the disease will have a normal life expectancy.
The leading causes of death in patients with lupus nephritis are:
- Infection
- Cardiovascular disease
- Cancer
Complications of lupus nephritis can include kidney failure in 10 to 30 percent of patients, and these patients may require a kidney transplant. Patients who develop end-stage renal disease have a 26-fold increased risk of death.
What Are Symptoms of Lupus Nephritis?
Symptoms of lupus nephritis may include:
- Protein in the urine (proteinuria)
- Urine may be foamy, bubbly, or frothy
- Blood in the urine (hematuria)
- Urine may appear pink or light brown
- Fluid retention (edema)
- Swelling in the legs, ankles, or around the eyes
- High blood pressure (hypertension)
- Weight gain
- Kidney problems
- Joint pain or swelling
- Fever with no known cause
- Muscle pain
- A red rash, often on the face, across the nose and cheeks (called a “butterfly rash” due to its shape)
How Is Lupus Nephritis Diagnosed?
Lupus nephritis is diagnosed with a patient history and physical examination, and tests such as:
- Urine test to check for protein and blood
- Blood tests
- Antiphospholipid antibodies
- Protein levels
- Cholesterol
- Glomerular filtration rate (GFR) which shows how well the kidneys filter waste
- Antinuclear antibodies (ANA)
- Kidney biopsy
What Is the Treatment for Lupus Nephritis?
Lupus nephritis is treated with medications such as:
- Corticosteroids, such as prednisone
- Immunosuppressive drugs, such as cyclophosphamide (Cytoxan) or mycophenolate mofetil (CellCept)
- Blood pressure medications
- Angiotensin converting enzyme (ACE) inhibitors
- Angiotensin receptor blockers (ARBs)
- Beta-blockers
- Calcium channel blockers
- Diuretics
- Other blood pressure medications
- Antimalarials such as hydroxychloroquine (Plaquenil)
- Some chemotherapy drugs
- Diet changes
- Reducing salt (sodium)
- Reducing protein
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https://www.kidney.org/atoz/content/lupus
https://www.allinforlupusnephritis.com/about-lupus-nephritis/signs-and-symptoms
https://www.niddk.nih.gov/health-information/kidney-disease/lupus-nephritis
https://academic.oup.com/ndt/article/27/8/3248/1816836