5 things to know about lupus kidney disease
Lupus nephritis (LOO-pus nef-RY-tihs) is the term used when lupus causes inflammation in the kidneys, making them unable to properly remove waste from the blood or control the amount of fluids in the body. Lupus nephritis most often develops within the first five years after the symptoms of lupus start, and usually affects people between the ages of 20 and 40.
As many as 40 percent of people with lupus, and as many as two-thirds of children with lupus, will develop kidney complications that require medical evaluation and treatment. But, because there are so few symptoms of kidney disease, kidney damage can happen before a person even knows they have lupus.
Here are 5 things you should know about lupus kidney disease:
- The specialist physician who treats people with lupus nephritis is a nephrologist. “Nephrologist” comes from the Greek word nephros, meaning “kidney.” Nephrologists are the physicians who treat the renal system, which includes the kidneys. They use various tests to monitor and diagnose lupus nephritis, including: urine tests, blood tests, and often a kidney biopsy. A rheumatologist—the specialist who treats disorders of the musculoskeletal system and autoimmune diseases such as lupus—will also be on the health care team for lupus nephritis.
- Lupus nephritis is usually treated with a combination of medications. The most commonly used medications are those that suppress the overactive immune system that causes the inflammation. If the kidneys become damaged from active lupus, a person might need to begin dialysis, in which a machine filters wastes from the blood several times a week. Only 15 to 20 percent of people with lupus nephritis will reach the point where dialysis or a kidney transplant is necessary.
- Children with lupus nephritis are treated with the same medications as adults with lupus nephritis. Corticosteroids, such as prednisone, and immunosuppressives, such as mycophenolate mofetil (CellCept®), are the most frequently used medications for people with lupus nephritis of any age. The dosages for children may be different, however, from dosages given to adults.
- Lupus kidney disease can develop during a pregnancy in women with lupus. A warning sign of kidney disease is swelling of feet and ankles. Because this is also common in pregnancy, it’s very important for pregnant women with lupus to continue to see their rheumatologist regularly throughout their pregnancy. Pregnant women also should immediately alert their rheumatologist and their obstetrician about any new symptoms.
- When a person has lupus kidney disease, their diet should be low in sodium (salt). High amounts of sodium cause the kidneys to work harder to filter the sodium from the blood, which can lead to high blood pressure. Therefore, it’s important to have a low-sodium diet when you have lupus nephritis.