Living with Lupus Nephritis - A Guide for Patients and Families

Cheryl Whitten
Cheryl Whitten
June 10, 2024
8
min read
Medically reviewed by:
Trager Hintze, PharmD
Living with Lupus Nephritis - A Guide for Patients and Families
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Lupus is a common and chronic disease that affects multiple organs. In the United States, lupus in males is less common than in females [1]. One in every 250 black women will develop lupus, and nine out of 10 of all people with lupus are women [1]. In addition, five out of 10 people with lupus will develop lupus nephritis, leading to a high prevalence [1].

What Is Lupus Nephritis?

Lupus nephritis is one symptom of the autoimmune disease called systemic lupus erythematosus (SLE) or simply lupus [2]. There are other forms of lupus, including drug-induced lupus, cutaneous lupus (affecting the skin), and neonatal lupus (affecting babies of women who have lupus) [2].

Some people develop rare forms of lupus, such as lupus panniculitis, which causes hard, tender lumps in the skin on the face, shoulders, and breasts [3].

What Causes Lupus Nephritis?

Lupus generally occurs when your immune system creates antibodies to your DNA and attacks multiple organs, causing inflammation and damage [2]. In particular, lupus nephritis happens when these antibodies link to DNA and accumulate in your kidneys, resulting in scarring and swelling in the blood vessels that filter waste [2].

Most people who have systemic lupus will develop lupus nephritis, but some people may be more likely [2]. For instance, lupus nephritis is more common in men, specifically African American, Asian, and Hispanic males [2]. Systemic lupus or SLE is more common in women, but lupus in men tends to be more severe, specifically lupus nephritis [2]. 

Symptoms of Lupus Nephritis 

Frequent urination is one of many possible indicators for lupus nephritis
Frequent urination is one of many possible indicators for lupus nephritis [4].

Lupus nephritis often doesn’t cause symptoms, so you may not know you have it [2]. Some people however may experience:

Most people who have lupus nephritis already have other signs and symptoms of systemic lupus [2]. These general symptoms may include [2]:

  • Oral ulcers or lupus mouth sores
  • Malar or butterfly rash across the face
  • Fatigue
  • Fever
  • Sore joints
  • Weight loss or gain

Systemic lupus can affect any organ, leading to other symptoms involving the heart, lungs, joints, muscles, and brain [5]. Some people develop lupus eyes, which leads to rashes, inflammation, and vision changes [5].

Lupus Nephritis Diagnosis

You’ll undergo regular kidney screening after you’re diagnosed with lupus. Your doctor will conduct a physical exam, review your history of symptoms and other conditions, and order some tests [4]. 

These tests include [2]:

  • Blood tests to check:
    • Creatinine levels
    • eGFR or kidney filtration rate
    • Protein levels
    • Cholesterol levels
  • X-rays or ultrasound
  • Biopsy to examine a small piece of your kidney under a microscope
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Impacts of Lupus on Kidney and Liver Health

Signs of lupus nephritis are visible in most patients with systemic lupus, even without kidney symptoms, making it a common but serious complication [2]. Treatment may also cause complications in other organs [2].

Lupus Nephritis and Kidney Function

Lupus nephritis impacts different kidney areas [2]. Your doctor will classify the condition based on where lupus nephritis develops and how advanced it is [2].

Eventually, the antibodies and immune cell deposits cause swelling, thickening, and scarring of the glomeruli, leading to poor filtration [2]. Your kidneys can’t reabsorb protein, causing it to leak into your urine, and they also can’t remove fluids properly, leading to swelling and weight gain [4].

You may also develop low levels of protein and high levels of fat and cholesterol in the blood, a condition known as nephrotic syndrome [6]. Advanced or untreated lupus nephritis may cause extensive scarring that leads to chronic kidney disease, persistent high blood pressure, or end-stage renal disease [2].

Lupus Liver Complications

Lupus can cause additional complications in the liver and digestive system, such as lupus hepatitis or lupus enteritis [5]. Lupus hepatitis is when the immune system attacks your liver and causes inflammation or damage, while lupus enteritis is inflammation of the bowel wall [5,7] .

Both of these conditions can occur as a symptom of active systemic lupus or as a complication of treatment. Lupus hepatitis causes elevated liver enzymes, nausea, vomiting, abdominal pain, dark urine, gray stool, and yellow eyes and skin [8].

The Importance of Home Testing

Testing is essential for the early detection of lupus nephritis and for monitoring overall kidney function [2]. Tests may be in-office or home urine tests

Early Detection and Regular Monitoring

Current guidelines recommend urine screening every three months after lupus diagnosis to monitor for signs of nephritis, including protein and blood in the urine [2]. Recognizing changes early on leads to prompt treatment. The earlier you start treatment, the slower the disease progresses and the better your outcomes [2].

Your doctor may order these tests, or you might do an at-home lupus self-test and have your doctor confirm the results.

Benefits of Home Testing 

Urine Test for Lupus Nephritis
Multiparameter urine test strips, such as Urinox-10, can check different urine parameters and are a valuable tool for monitoring and managing lupus nephritis. Learn more.

Lupus patients must deal with many tests and appointments. Home tests, such as the Diagnox Urinox-10 or Urine Protein Test, simplify screening and make it easy to monitor urine without disrupting your lifestyle. 

The Urinox-10, for example, tests 10 parameters, providing insight into your kidney function and liver and urinary health from the comfort of your home. These dipstick tests are easy to use and provide medical-grade results, showing levels of:

Living with Lupus Nephritis

Most patients with lupus nephritis do well and have a good outlook, though you may need to take medications or other treatments long-term [4]. Maintaining healthy habits, good lupus self-care, and your treatment schedule is essential. 

Lifestyle Management Strategies 

Lupus symptoms may come and go through periods of flare-up and lupus remission [9]. Living with a chronic disease can be challenging, but taking an active role in your health can help. Manage your stress, exercise daily, and lean on your family for support to improve your well-being [9].

In addition, following your treatment plan is essential. See your lupus specialist regularly as instructed, and take the prescribed medications. These might include [4]:

  • Corticosteroids
  • Immune-suppressing drugs
  • ACE inhibitors for blood pressure
  • Diuretics
  • Monoclonal antibodies

Diet 

Changing your diet may help control your symptoms and improve your kidney function. Incorporate a kidney-friendly diet with [10]:

  • Low sodium and salt
  • Small portions of protein
  • Lean meats 
  • Fresh fruits and vegetables
  • Whole grains 
  • Low-fat or fat-free dairy foods

Follow this link to learn more about diet and lifestyle tips to improve kidney health.

Monitor Kidney Health With Diagnox

Regular screening and attention to health are essential in managing kidney conditions. Diagnox's clinical-grade tests provide easy-to-read results you can trust from the comfort of your home. Gain insights into your kidney health and take action with Diagnox. Get started now

References

[1] National Institute of Health Staff, “Lupus & Kidney Disease (Lupus Nephritis),” National Institute of Health. [Accessed June 5, 2024].

[2] R. Musa, L. Brent, and A. Qurie, “Lupus Nephritis,” StatPearls Publishing [Accessed June 5, 2024].

[3] A. Bednarek et al, “Case report on a patient with lupus panniculitis,” Advances in Dermatology and Allergology vol. 32,1, pp 59-62, 2015 [Accessed June 5,  2024].

[4] National Kidney Foundation Staff, “Lupus and Kidney Disease (Lupus Nephritis),” National Kidney Foundation, Available Online here, [Accessed June 5, 2024].

[5] M. Cojocaru et al, “Manifestations of systemic lupus erythematosus,” Maedica vol. 6,4, pp 330-6, 2011 [Accessed June 5, 2024].

[6] National Institute of Health Staff, “Nephrotic Syndrome in Adults,” National Institute of Health [Accessed June 5, 2024].

[7] J. Potera et al, “Lupus Enteritis: An Uncommon Presentation of Lupus Flare,” Cureus vol. 13,9 e18030, September 2021 [Accessed June 5, 2024].

[8] Lupus Foundation of America Staff, “Lupus and the Liver,” Lupus Foundation of America [Accessed June 5, 2024].

[9] Lupus Foundation of America Staff, “Lupus Symptoms,” Lupus Foundation of America [Accessed June 5, 2024].

[10] National Kidney Foundation Staff, “Lupus Nephritis & Your Kidneys,” National Kidney Foundation [Accessed June 5, 2024].

About the Author
Cheryl Whitten

Cheryl Whitten is a health writer with a background in allied health care as an herbalist and clinical aromatherapist. She holds a Bachelor of Arts in English literature from Athabasca University and certificates from the University of Maryland and Wild Rose College. She writes for leading health and lifestyle websites with a focus on health, wellness, and consumer products.

About the Reviewer
This blog was
Medically reviewed by:
Trager Hintze, PharmD

Trager Hintze is a clinical assistant professor and emergency medicine clinical pharmacist located in College Station, Texas. He has a bachelor's degree in biology as well as a Doctor of Pharmacy degree. He balances teaching at Texas A&M University College of Pharmacy and practicing emergency medicine at St. Joseph Regional Health Hospital.

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