Kidney Disease
The application of these drugs typically varies according to classification:
- Corticosteroids (such as prednisone, prednisolone and methylprednisolone, or Medrol) are considered necessary in the initial treatment in virtually all forms of lupus nephritis.
- Corticosteroids are the only type of drug required for those with Class II (mesangial nephritis).
- A combination of corticosteroids and immunosuppressives are used to treat most people with Class III (focal proliferative nephritis), Class IV (diffuse proliferative nephritis) or advanced Class V (membranous nephropathy).
- Corticosteroids are the only type of drug required for those with Class II (mesangial nephritis).
Several promising experimental therapies for lupus nephritis are currently being studied. These include:
- newer immunosuppressive drugs like cyclosporine and mycophenolate mofetil (CellCept)
- the removal of antibodies associated with lupus nephritis by selective plasmapheresis
- the administration of biologic agents that suppress the immune system.
- the removal of antibodies associated with lupus nephritis by selective plasmapheresis
Kidney Failure
Despite the prescribed treatment, some people with lupus nephritis do have progressive loss of kidney function. In the case of complete failure of both kidneys, dialysis, and eventually kidney transplantation will be required.
Dialysis can be done in two ways:
- Hemodialysis passes the blood through a dialysis machine and filters it directly.
- Peritoneal dialysis places fluid in the abdominal cavity and subsequently removes it.
Kidney transplantation has been very successful in people who have had kidney failure from lupus nephritis. Usually they are kept on artificial dialysis until there is little or no evidence of active lupus before the transplantation procedure is performed. Afterwards, immunosuppressive drugs will be used to prevent rejection of the transplanted kidney.
Conclusion
Over the past several decades, there have been major advances in the understanding of what causes lupus nephritis and, in particular, improvements in treatment. Today, more than 80 percent of people with lupus nephritis will live a normal life span.
Related Information
On this web site
NSAIDs
Steroids
Immune Suppressing Drugs
Medications
On the Internet
MedlinePlus: Drug Information
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK):
NIDDK: Kidney Disease and Kidney Failure
NIDDK: Hematuria
NIDDK: Kidney Biopsy
NIDDK: Proteinuria
NIDDK: Your Kidneys and How They Work