Studies revealed that about a third of patients that have systemic lupus erythematosus can develop a kidney disease called lupus nephritis or lupus glomerulonephritis.Lupus nephritis usually shows very few signs. It doesn’t cause pain or burning during urination and also it does not produce pain in the abdomen or back.The first symptom the patient with lupus nephritis usually experiences is puffiness in the legs, ankles or fingers. This happens because the loss of protein in the urine may lead to fluid retention with weight gain and swelling.
Sometimes the fact that a patient has lupus nephritis is discovered only after urine studies are made. It is very possible that if there is made another urine test, the urine abnormalities to disappear. But there are patients in which the abnormal findings on urine studies persist or can become even worse in time. This kind of patients require more studies to determine the best treatment to control the disease, because there appears the risk for loss of kidney function.
It is important to know that patients having lupus can experience some symptoms that confuse them and think they have lupus nephritis. For example infections of the urinary tract with burning on urination, or medications used in lupus treatment may produce signs that can start the confusion.There are some tests that can be done in order to find out if a patient has lupus nephritis.
Urinalysis is the most used and the most simple test to do. A urine sample is studied to find out if there is protein and blood cells which are not normally found in the urine.If in the urine sample there are found red blood cells, white blood cells, casts(excretion in the urine of protein or blood cells that collect within the tubules of the kidney), or there is discovered the presence of protein, there exists the possibility of lupus nephritis, and further tests are necessary.Sometimes, it is done a urine collection over a period of 24 hours to measure the kidneys’ ability to filter waste products.
Blood studies can also be performed, and we can mention the blood urea nitrogen and serum creatinine. These are tests that are made to find out if waste products are being removed properly by the kidney and are not building up in the blood.By measuring the serum albumin, it can be determined if there is a low protein level in the blood, and chemistry studies such as the serum sodium, potassium, and bicarbonate determine the imbalances of salt and water in the blood.There can be also made blood tests in order to determine if there are abnormalities of the immune system.
An intravenous sonogram or pyelogram can be made to determine the size and shape of the kidneys. Usually this test takes place before a kidney biopsy.The kidney biopsy takes place in order to confirm the diagnosis of lupus nephritis. It is made by inserting a needle through the skin of the back and removing a tiny piece of the kidney.Then, the small part taken from the kidney is analyzed under the microscope in order to determine how much inflammation or permanent damage is present within the kidney.
There are four most common types of nephritis: focal or diffuse proliferative nephritis, mesangial nephritis and membranous nephritis.
The treatment for lupus nephritis must be individualized, because there are different patients having different needs. It is important that all factors that appear to be taken in consideration when deciding the treatment.General principles of medical management of kidney disease include anti-hypertensive drugs to control increased blood pressure, diuretic agents to help eliminate excess fluid, changes in the diet to control the intake of salt, proteins and calories. These are very important in lupus nephritis.
Corticosteroids are often used to treat lupus nephritis. We can mention here prednisolone, prednisone and methylprednisolone. There still are some unanswered question about how corticosteroids work and how they may be most effectively used. Usual, high doses of corticosteroids are given until there appears improvement in the lupus nephritis. Then , the dose is reduced, but there is done a careful observation by the physician to make sure that the nephritis doesn’t get worse.If corticosteroids are given for long periods, there can appear side effects, like easy bruising, increase in appetite and fluid retention with weight gain, cataracts, thinning of the hair, an increase in the risk of infection, diabetes and other.
When patients do not respond at corticosteroid treatment, they are given Cytotoxic or immunosuppressive drugs such as azathioprine or cyclophosphamide. The effect of these drugs is to block the function of the immune system.As a result, further damage to the kidneys is prevented. However, even if these drugs may be beneficial, they can also bring serious complications.
Although there is appropriate treatment, there are patients that develop progressive loss of kidney function and renal failure. This requires the use of artificial dialysis, and that can be done by hemodialysis or peritoneal dialysis.Also, it can be made a kidney transplantation, and it is known that this has been very successful in patients with renal failure from lupus nephritis.
Over the years, science advanced in the understanding of what causes lupus nephritis, and there were made improvements in ways to treat patients.
For more resources about discoid lupus please review this http://www.lupus-guide.com/lupus-treatment.htm or even http://www.lupus-guide.com/discoid-lupus.htm
Groshan Fabiola
http://www.articlesbase.com/health-articles/things-you-should-know-about-kidney-disease-and-lupus-115047.html
4 comments ↓
lupus, kidney disease, anemia, diabetes?
I recently had bloodwork done as well as a urine sample.
I gained about 25 pounds last year in a short period of time.
I have been very tired as well, for most of the year.
I took depoprvera and ended up having bloodclots for 6 months (not very fun if that was my first six months of marriage)
And have been miserable since….
My mother has lupus, but in our family it seems to skip generations.
things that were ‘out of range’ were:
platelet count: 431 (when it should be between 150-400.)
urine: cloudy.
urine protein: >0.15 (when it should be <0.15.)
urine keytones: >1.5 (when it should be <1.5)
ferritin: 14 (normal range is 15-180)
Anyone know anything about any of this?
Please let me know, thanks so much!
I am going to add symptoms like: night sweats, always itchy, want to pass out after lunch, go pee in the middle of the night, veeeeery tired all the time, no energy, always hungry but nothing appeals, blood clotty periods, cold feet.
Might I also add that I have been on anti-depressants (zoloft) for about two years, (I have very unstable emotions).
5’0
130lbs
20.5yrs
Scottish, English, Irish, Norweigian, Hawaiian, Indian (like canadian aboriginal), Italian and Flemmish.
Also, I might add I was diagnosed with anemia in grade 2. My mother said when I was 11, when I got my first period, she took me in for a blood test, and they said I was anemic then too.
And also, when I was 16, I had a kidneystone. I never found out why, or what kind it was though…
I have had lupus for about 30 years and I didn’t think it was hereditary.The way I understand the blood count was bad if it were a low count. I hope it isn’t lupus you have.
References :
The normal range for platelet counts differs from lab to lab, and many labs use 150-450. Moreover, slightly high platelets are of no consequence. So, no need to worry about your platelets.
Ferritin that low usually indicates low iron levels in the body, which can lead to iron-deficiency anemia. (Was your hemoglobin normal?) Due to menstrual blood loss, young women are particularly likely to have low iron levels. You can increase your iron levels by taking supplements/vitamins, or naturally through high-iron foods.
Cloudy urine can mean many different things — one of which is small amounts of blood in the urine, which is a sign of kidney disease. Does your test report say whether your urine was positive or negative for blood?
High urine protein is also a sign of kidney disease, but can go up temporarily after rigorous exercise or during a bladder infection. You should have your urine test repeated to make sure the urine protein returns to normal.
Having ketones in the urine is also abnormal. While it can occasionally happen during starvation (if you fasted for a long time), it can also be a sign of diabetes mellitus ("sugar diabetes"). What does your test report say about sugar in the urine? More importantly, what was your blood sugar?
With your recent weight gain, urine protein and urine ketones, you should definitely be screened for diabetes. If your recent blood tests didn’t include fasting blood sugars (glucose), ask your doctor to have that done.
Finally, lupus can be extremely hard to diagnose, especially in the early stages. None of the tests you gave above is a good test for lupus (although having a low ferritin and normal/high platelets make active lupus less likely), so if you are really worried, talk to your doctor to have a blood test called ANA (anti-nuclear antibodies) done.
Good luck!
References :
You have a lot more going on that most doctors would want to diagnose, much less a bunch of amateurs on yahoo.
Lupus is not hereditary like sickle cell is. People who develop lupus have a predisposition to it. But there have been studies where there are identical twins: one develops lupus and the other does not. Some researchers believe that you need a combination of a predisposition to autoimmunity AND triggers to develop lupus. Some researchers consider hormonal birth control to be a trigger, others do not. The jury is still out. But it is possible.
Lupus people often have low platelet counts. Cloudy urine could come from lots of things, most likely a low grade infection.
For protein in the urine .15 WHAT? At my worst, I had 1400 mg protein in 24 hours. Your figure is useless to me.
Keytones, I believe, have to do with protein metabolism. Not sure.
Ferritin is iron.
For most of the stuff you don’t tell us how FAR out of range it is.
And finally, none of those tests is definitive for lupus. Go to the link below to understand your lab tests. And please ASK YOUR DOCTOR what they mean! That’s what s/he gets paid for!
References :
http://www.labtestsonline.org/understanding/index.html