nephritis is a kidney disorder
that is a complication of systemic
lupus erythematosus , characterized
by damage to the glomerulus and progressive
loss of kidney function.
incidence, and risk factors
nephritis is one complication of?systemic
lupus erythematosus ( SLE ). It is related
to the autoimmune process of lupus, where
the immune system produces antibodies (
antinuclear antibody and others) against
body components. Complexes of these antibodies
and complement accumulate in the kidneys
and result in an inflammatory response .
causes various disorders of the internal
structures of the kidney, including interstitial
nephritis , mesangial GN, membranous GN
, membranoproliferative GN, diffuse proliferative
GN, and others.
often causes nephrotic syndrome (excessive
protein excretion) and may progress rapidly
to renal failure . There is progressive
azotemia (the accumulation of nitrogenous
waste products in the bloodstream) and urinary
abnormalities including protein and blood
in the urine .
nephritis affects approximately 3 out of
10,000 people. Systemic lupus erythematosus
is most common in women 20-40 years old.
It runs in families and is more common in
blacks. It may be related to other autoimmune
disorders including rheumatoid arthritis
and scleroderma . It has been known to be
triggered by pregnancy in some cases.
In children with
SLE, about half will have some form or degree
of kidney involvement.
- Blood in the
- Foamy appearance
- Swelling of any
area of the body
- Elevated blood
of SLE may include the following:
- Joint pain
- Joint swelling
- Joint redness
on the face but may occur on other
- Chest pain
, sharp and stabbing
- Sun sensitivity
- fever may
develop after exposure to sun
- rash may
develop after exposure to sun
- Mouth ulcers
- Neurologic changes
Examination indicates decreased kidney functioning
with edema and may indicate?kidney failure.
Blood pressure may be high. Abnormal sounds
may be heard when the doctor listens to
the heart and lungs, indicating fluid overload.
nephritis is usually discovered during investigation
of the causes of reduced kidney function.
Fewer than half?of patients?have other symptoms
of?SLE at the time of diagnosis of lupus
urinalysis is abnormal with protein
, casts , and red blood cells present
in the urine.
An ANA titer is high.
Syphilis tests may be falsely positive.
BUN and creatinine may be used to assess
A lupus erythematosus (LE) cell test
A kidney biopsy is indicated, not to
diagnose lupus nephritis, but to determine
is appropriate for the renal component
A urine immunoglobulin light chain is
disease may also alter the results of the
- Complement component
The goal of treatment is improvement of
kidney function. Corticosteroids or other
immunosuppressive medications are often
effective in reducing symptoms. Whether
high doses of corticosteroids or immunosuppressives
are likely to be beneficial depends on the
precise findings on kidney biopsy .
may be necessary to control symptoms of
acute or chronic renal failure . Renal failure
may be severe enough to require dialysis
even if no other symptoms of SLE are present.
kidney transplant may be recommended to
treat kidney failure resulting from lupus
The outcome varies. It is usually worse
with diffuse proliferative lupus nephritis
(one specific form of the disorder). As
with SLE , the course is variable, with
exacerbations ( acute episodes) and remissions
(symptom-free periods). Some cases of lupus
nephritis may progress to chronic renal
80% of people with lupus nephritis severe
enough to require dialysis or transplantation
will survive for more than 5 years after
treatment. Although lupus nephritis may
recur in a transplanted kidney, it rarely
leads to end stage renal disease. People
with active lupus should not undergo transplantation.
- Acute renal failure
- Chronic renal
- End-stage renal
- Nephrotic syndrome
health care provider
Call your health care provider if blood
in the urine or swelling of the body develops.If
you have lupus nephritis, call your health
care provider if there is decreased urine
There is no known
prevention for lupus nephritis.
to "Kidney Treatment"