Approximately one-third of people with systemic lupus erythematosus (SLE) require medical treatment for inflammation of the kidneys. Lupus is a chronic inflammatory autoimmune disease that affects many parts of the human body, with the kidneys being most vulnerable.
How Lupus Impairs Kidneys
A healthy immune system attacks foreign viruses and bacteria by producing proteins called antibodies. In people with lupus, these antibodies, also called auto-antibodies, attack normal healthy tissue. The capillaries of the kidneys can become inflamed as the auto-antibodies build up. This lowers kidney function and can cause kidney failure.
Lupus nephritis, the inflammation of the filtering units in the kidneys, is not the only cause of kidney disease in people with lupus. Aspirin and nonsteroidal anti-inflammatory drugs (NSAID) used in lupus treatment can impair kidney function and cause fluid buildup.
Painkillers can often adversely affect the kidneys, and as lupus sufferers often require medications for pain, it is important that kidney functions be regularly monitored in lupus patients.
Medical Tests for Early Signs of Lupus Nephritis
Also called lupus glomerulonephritis, lupus nephritis may be present without signs or symptoms in the early stages, except for those found in medical tests.
Elevated red blood cells and protein levels can show up in a urinalysis done by a health care professional and may be the first sign of a kidney problem in lupus patients. A blood test called serum creatinine can show how well the kidneys eliminate waste products. A kidney biopsy is often recommended if lupus nephritis is detected. The biopsy can help the doctor identify severity of the nephritis and determine proper treatment.
High Blood Pressure as a Warning Sign
Lupus nephritis can lead to high blood pressure, which in turn can further damage the kidney capillaries. The National Institutes of Health and the National Heart, Lung and Blood Institute recommend that people with lupus nephritis maintain a blood pressure of 130/80 or below.
Edema
Often the first physical symptom of kidney inflammation in people with lupus, edema usually presents itself as swelling of the legs, ankles and feet. If the body fills with waste products and extra water, edema may occur in the hands as well as the lower extremities. Symptoms of tiredness and weakness will appear as the body is stressed by the lack of clean blood it needs to function. Untreated, this will lead to uremia and cause coma, seizures and death.
Blood in the Urine
Hematura, or blood in the urine, is one of the first signs of glomerula disease. This may be treated with immunosuppressive drugs or steroids. Glomerula disease attacks the glomeruli in the kidneys. Kidney diseases caused by autoimmune diseases such as lupus are grouped in the glomerula disease category.
Other Signs and Symptoms
Although early kidney disease may not show signs or symptoms, as it progresses subtle signs may become apparent. Changes in frequency of urination, muscle cramps or a darkening of the skin may occur. A person may feel tired, have trouble with concentration and suffer bouts of vomiting or nausea. Loss of appetite or a feeling of numbness or itchiness may also indicate kidney problems.
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