Systemic Lupus Erythematosus (SLE ), or simply known as Lupus, is an auto-immune disease. Autoimmune diseases develop when the individual’s immune system attacks its own organs and causes damage. As the name implies, SLE is a systemic disease, meaning it can affect different organs of the body in various ways.
When lupus affects the kidney, it is called lupus nephritis. A healthy kidney is composed of nearly 1 million filters, which are called glomeruli. This is the area of the kidney most affected by lupus. However, this disorder can affect almost any part of the kidney, including the drainage system within the kidney and other surrounding tissue.
If the kidney is affected by lupus nephritis, it can cause protein in the urine, called proteinuria, which can make the urine appear foamy. It can also be associated with blood in the urine, or hematuria, that can be detected under the microscope, and in some cases, can be visible in the urine, causing it to appear pink, red, or rust-colored.
If left untreated, the inflammation caused by the immune system can lead to permanent scarring of the kidney filters and surrounding tissue, causing progressive kidney failure and the need for dialysis. A kidney biopsy is important in determining the extent and type of inflammation. The results from the kidney biopsy help to select the most appropriate medical therapy.
Symptoms of Lupus
Common symptoms of SLE include joint inflammation and pain, characteristic rash on the face and cheeks, and inflammation of many vital organs such as the heart (myocarditis and pericarditis), the lung (pleuritis), pancreas (pancreatitis), and colon (colitis).
Diagnosis of Lupus
Besides the clinical manifestations, laboratory tests are available to support the diagnosis of lupus. Those tests include, but are not limited to, ANA, anti-dsDNA, C3, C4, SSA, SSB, etc.
Treatment for Lupus
Drug therapy, in addition to lifestyle modifications, varies based on the severity of the disease process and the type of organ involved. For instance, isolated skin and joint manifestations are usually treated with Hydroxychloroquine, painkillers as needed, and sometimes low dose steroids and Belimumab.
More severe clinical manifestations, especially with organ involvement, such as the brain and kidneys, require a more aggressive immunosuppression regimen. The list of these immunosuppressive drugs has grown in the past decade and there are multiple ongoing clinical trials.
Our dedicated Nephrologists at the Kidney and Hypertension Center will work closely with your other specialists who are involved in your care to assure that every effort is made to preserve your kidney function. We will help guide you through the treatment options and counsel you along the way.