Kidney Disease
Treatment and Therapy
Treatment for lupus nephritis must be individualized to the needs of the specific person. All of the following must be taken into consideration:
- the amount of edema (swelling)
- urine abnormalities
- amount of protein in the urine
- reduction of kidney function
- findings of the kidney biopsy.
- urine abnormalities
Diuretic agents may be used to help eliminate excess fluid. Anti-hypertensive drugs can control increased blood pressure. Anticoagulation drugs are used in case of complications arising from blood clots. Changes in the diet can be made to control the intake of salt, proteins, and calories.
There are two major forms of drug therapy used for lupus nephritis: corticosteroids to control inflammation, and cytotoxic or immunosuppressive drugs to suppress the activity of the immune system.
Corticosteroids
Corticosteroids have been used to manage lupus nephritis for nearly forty years. Still, there are many unanswered questions as to exactly how they work and how they may be most effectively used.
High doses of corticosteroids, or even corticosteroids given for extended periods of time, may cause a number of side effects (some side effects can be lessened by a low calorie and low salt diet):
Cytotoxic or immunosuppressive drugs are generally regarded as standard treatment for people with serious lupus nephritis. These drugs block the function of the immune system, which in turn prevents further damage to the kidneys. The most commonly used is cyclophosphamide (Cytoxan). Immunosuppressives that are used less frequently include: azathioprine (Imuran), chlorambucil (Leukeran), and cyclosporine (Sandimmune or Neoral).
- increased appetite
- fluid retention with weight gain
- puffy face
- easy bruising
- moodiness
- loss of mineral from the bones
- cataracts
- thinning hair
- an increased risk of infection and diabetes.