Kidney Failure in People With Lupus Nephritis
Inflammation from lupus can cause a type of kidney disease called lupus nephritis. Learn more about how lupus affects the kidneys and lupus nephritis.
For some people, lupus nephritis can lead to chronic kidney disease (CKD), and with so much irreversible damage, both kidneys stop working. When this happens, it is called kidney failure.
Although it is important to learn about CKD, its prevention, screening and prevention of progression, this work will focus on kidney failure or end stage kidney disease.
What is kidney failure?
Your kidneys clean your blood by filtering out waste and extra water. Kidney failure happens when both kidneys stop filtering waste and extra water properly.
Doctors use a test called eGFR (estimated glomerular filtration rate) to find out how well your kidneys are working. If your kidneys have a low percentage of function, that means they aren’t working very well to filter out waste and extra water. Kidney failure means the kidneys have less than 15 percent of function. Your doctor might also use the terms “renal failure, “end-stage renal disease,” or “end-stage kidney disease” when talking about kidney failure.
Symptoms of kidney failure can be different for different people. But some common symptoms include:
- Feeling very tired
- Throwing up or feeling sick to your stomach
- Trouble concentrating or confusion
- Swelling around your hands, ankles, or face
- Having to pee more often
- Muscle cramps
- Dry or itchy skin
- Not having an appetite or food tasting metallic (like metal)
If you have any of these symptoms, talk to your doctor.
Why do some people with lupus nephritis have kidney failure?
In lupus nephritis, the inflammation caused by lupus damages your kidneys. Over time, this damage can cause the kidneys to fail.
The good news is that treatments for lupus nephritis generally work well and can prevent the disease from causing kidney failure. But some people may have kidney failure even if they’re getting treated for kidney problems. About 1 to 3 out of every 10 people with lupus nephritis will have kidney failure.
These are conditions in the places where you live, learn, work, and play that can affect your health. SDOH include factors like air and water quality, experiences with racism and discrimination, and access to things like health care, education, and healthy foods.
We know that people of color experience lupus nephritis at higher rates than White people. Experts aren’t exactly sure why, but SDOH may play a role.
People with kidney failure who live in rural areas or have less income may face barriers to treatment. That’s because dialysis clinics and transplant centers are usually located in places with a higher number of people. Plus, these treatments can be expensive.
Learn more about how lupus affects different groups of people differently.
How is kidney failure treated?
Without treatment, kidney failure is fatal. But there are treatments that can help — like dialysis and kidney transplantation.
Dialysis
Dialysis is a treatment that takes over the job of the failing kidneys to filter and clean your blood. There are 2 types of dialysis :
- Hemodialysis. This type of dialysis involves using a dialysis machine to clean your blood. People get hemodialysis at a dialysis clinic or hospital or at home. Each session takes about 3 to 5 hours, and most people need to go 3 or 4 days each week.
- Peritoneal dialysis. For this type of dialysis, a catheter will be placed into your stomach. The catheter is connected to a bag of dialysis solution. The solution flows through the catheter in your belly, absorbs waste and extra fluid, and then drains back into the bag.
Kidney dialysis is a life-saving treatment, but it may have a big impact on a person’s life. Individual treatment sessions can take up a lot of time. And because dialysis requires special equipment, people with kidney failure need to carefully plan their activities around dialysis treatment.
Read more about dialysis — including how it can affect your daily life.
Kidney transplant
A kidney transplant is surgery to put in a healthy kidney from a donor. Donor kidneys can come from a living person including but not limited to family members, friends, or deceased people who chose to donate their organs.
Before doing a kidney transplant, doctors will carefully check blood and tissue types for you and the donor to see if the donor kidney is a good match. This can help prevent future health problems. It can take time to find the right match — many people who need a kidney wait for 3 to 5 years before receiving a transplant. People with kidney failure who are waiting for a transplant need to do dialysis until they can have surgery.
Kidney transplant comes with risks, including bleeding, infection, transplant rejection and recurrence of lupus nephritis. Transplant rejection means the body attacks or rejects the new kidney. If you get a kidney transplant, you’ll need to take medicines to try to prevent transplant rejection.
Unfortunately, not everyone who needs a kidney transplant can get one. That’s because there are not enough donor kidneys for the people who need them. In addition, you might not be approved for a transplant if you’re above a certain age or have another serious health problem, like cancer.
Learn more about getting a kidney transplant.
Supportive care
Supportive care (also called palliative care) is care that aims to help people manage their kidney failure symptoms and feel better. You can have supportive care alongside dialysis or a kidney transplant.
Some people with kidney failure may choose not to have treatment. In these cases, supportive end-of-life care can keep people comfortable until they pass. People with kidney failure may live from one week to several weeks without treatment. Deciding not to have treatment for kidney failure (or to stop treatment) is a personal decision, but it’s important to talk with loved ones and your doctor about your choice.
Read more about supportive care for people with kidney failure.
Learn more about kidney failure
Check out these resources to learn more about the how lupus affects the kidneys, kidney failure, and treatment: