Your kidneys play an important role in your overall health and lupus can affect them in ways that are not always easy to notice at first. During this event, Lupus & You: Protecting Your Kidneys, we discussed why kidney health matters, how lupus nephritis (LN) is identified and treated and what people living with lupus should know to help protect their kidneys over time. The conversation also highlighted the emotional impact of kidney complications and the importance of staying engaged in your care. 

We were joined by Ashira D. Blazer, MD, MSCI, Rheumatologist and Assistant Professor, University of Maryland DIvision of Rheumatology and Brad Rovin, MD, FACP, FASN, Nephrologist and Professor, The Ohio State University Wexner Medical Center and Monica Francis and Timeka Giffin, National Lupus Kidney Care Support Group Facilitators and lupus warriors. Together, they shared clinical expertise and lived experience to help attendees better understand LN, recognize warning signs, navigate treatment and feel more empowered to advocate for their kidney health. 

Top Takeaways from the Webinar: 

• Regular kidney monitoring can help catch problems early, even before you notice symptoms. Kidney problems do not always cause noticeable symptoms right away and that is why routine urine tests, blood work and blood pressure checks are so important. Regular monitoring can help identify kidney involvement early, before more serious damage occurs and gives you a chance to address concerns sooner with your health care team. 
• Early action and consistent treatment can help protect your kidneys over time. Recognizing kidney involvement early and starting treatment as soon as possible can make a real difference. Staying on top of appointments, understanding your lab work and following your treatment plan are important steps in protecting kidney function and supporting long-term health. 
• Health habits can support your kidney health but they work best alongside medical care. Small, consistent steps like staying hydrated, being mindful of salt intake, getting enough rest and supporting your overall wellness can play an important role in kidney health. While these lifestyle habits do not replace treatment for LN, they can support your body and help you feel more engaged in your care. 
• Support and self-advocacy can make kidney health challenges feel more manageable. LN, dialysis and kidney transplant can bring physical, emotional and lifestyle challenges. Asking questions, speaking up about your concerns, leaning on loved ones and connecting with others who understand can help you feel more supported and confident as you navigate your care. 

Our Health Education Specialists also collected our speakers’ answers to attendees' questions from the event:

What are some signs that lupus may be affecting the kidneys?

Lupus nephritis (LN) does not always cause symptoms at first, which is why routine monitoring is so important. Many people do not realize their kidneys are involved until lab work shows changes. As the disease gets worse, it can cause swelling (usually in the feet, ankles, legs or face), foamy urine, peeing more than usual (especially at night) and high blood pressure.

How often should people with lupus have their kidneys checked?

Everyone living with lupus should be screened regularly for LN, even if they feel fine. Kidney screening should happen at least once every six months and should include checking blood pressure, a urine screen for protein and blood tests that help monitor lupus activity and kidney function. In some cases, your doctor may recommend monitoring more frequently. Do not assume that no symptoms means no kidney involvement.

"You need to be proactive and make sure that your kidney labs are being checked frequently to ensure treatment is going in the right direction," Dr. Brad Rovin said.

What is a kidney biopsy and why is it important?

A kidney biopsy is considered the gold standard for diagnosing lupus nephritis. A biopsy helps confirm whether lupus is affecting the kidneys and how much damage may be occurring to the kidneys. This information helps the medical team choose the most appropriate medications and tailor your treatment plan to you. While a biopsy can feel scary, it is an important tool for understanding what is happening in the kidneys and guiding the next steps in care.

"It's the best way for us to know for sure this is lupus affecting the kidney," Dr. Ashira Blazer said. "It shows how much of the kidney is inflamed and which parts of the kidney are inflamed. and then also whether or not there's scarring in the kidney that may not respond to treatment."

What treatments are available for lupus nephritis?

Treatment for LN often includes a combination of medications. Hydroxychloroquine remains an important medication for many people with lupus and can help reduce flares and long-term organ damage. Steroids are often used early to control inflammation but the goal is to typically taper them down as safely and quickly as possible. Other commonly used treatments for LN include newer targeted biologic medications. Treatment plans should be individualized, proactive and closely monitored over time.

Do people with lupus need to see a nephrologist before they have kidney problems?

Not everyone with lupus needs to see a nephrologist right away. Not all people with lupus will develop lupus nephritis, the first step is making sure kidney screening is happening consistently with your rheumatologist. If those labs begin to show signs of kidney involvement, that is the time to talk to your rheumatologist about involving a nephrologist in your care. Strong collaboration between rheumatology and nephrology can help people with lupus get the right care quickly when it is needed.

What role do diet and lifestyle habits play in protecting kidney health with lupus?

Healthy lifestyle habits can support overall wellness and kidney health but diet, vitamins and supplements alone cannot prevent LN. Healthy eating, staying hydrated, getting enough rest and other supportive habits can be helpful but they are not a substitute for regular kidney monitoring or medical care.

"Diet and medicine should go hand in hand," Dr. Blazer said. "There is wellness and there is illness. These two things are necessary, but wellness doesn't take care of illness treatment. Illness treatment doesn't take care of wellness. You need both."

What should I ask my doctor if I am concerned about my kidney health?

A helpful starting point is to ask how often your kidneys are being monitored and what tests are being checked. You can also ask whether there are signs of protein or blood in your urine, whether your blood pressure is in a healthy range and if any of your lab results suggest inflammation or kidney involvement. Understanding your labs and asking follow-up questions can help you feel more confident and engaged in your care.

"If you're taking drugs that are making you absolutely miserable," Dr. Rovin said, "you should sit down and talk with your doctor and say, 'I'm miserable. Could we try something else?' I I do that all the time with my patients." 

Why is it important to take LN treatment(s) consistently, even when symptoms improve?

LN treatment is not just about feeling better in the moment, it is about protecting the kidneys from ongoing inflammation and preventing long-term damage. Even when symptoms improve or lab values start to stabilize it is important to continue medications as prescribed and attend follow-up visits so your health care team can monitor progress and adjust your treatment, if needed.

How can people cope with the emotional impact of lupus nephritis, dialysis, or transplant?

Kidney complications can bring fear, exhaustion, stress and major lifestyle changes. Dialysis and kidney transplantation can affect routines, independence and overall emotional well-being and it can be hard to adjust when treatment becomes part of daily life. Asking questions, advocating for yourself, leaning on loved ones and finding support from people who understand can help make the experience feel less isolating and more manageable.

Lupus & You is a free educational series where people with lupus and their family and friends can learn more about the latest in lupus research and managing the disease. You can find slides and additional resources from this Lupus & You here.

Our next Lupus & You will take place on August 26, 2026, focused on Tips for Your Journey. Find more information about upcoming and past Lupus & You events here.

Authored by:

Ashley Holden, MEd, CHES

Ian Decker , Health and Communications Writer

This blog post and the lupus resources found on the National Resource Center on Lupus are, in part, supported by the Centers for Disease Control and Prevention under Cooperative Agreement Number NU58 DP006139. The contents are solely the responsibility of the developers. Points of view or opinions do not, therefore, necessarily represent official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.

The Lupus Foundation of America and our health education specialists have answered some of your most common questions. The provided answers are for educational and information purposes only. Consult with your doctor/health care team for medical advice.