Whats The Prognosis For People With Lupus Nephritis
People who receive timely treatment for lupus nephritis have a positive outlook. People with lupus nephritis who receive medication, dialysis or a kidney transplant tend to do as well as people with other kidney diseases who receive these treatments. But most people need to manage the disease with medication or dialysis for the rest of their lives.
What Is Lupus How Does It Affect Your Kidneys
Lupus occurs when your immune system becomes overactive and attacks healthy tissue. There are four main types of lupus, including:
- Systemic Lupus Erythematosus
- Neonatal Lupus Erythematosus
- Drug-induced Lupus Erythematosus
SLE is the most common type of lupus. It can damage your skin, joints, kidneys and brain. When SLE attacks your kidneys, its called lupus nephritis. Lupus nephritis is often referred to as lupus kidneys and these are very common. Half the people who have SLE are estimated to develop lupus kidneys later.
Ways Lupus Affects The Eyes
Lupus is a chronic autoimmune disease that affects the skin, blood vessels, joints, heart, kidneys, and nervous system. Lupus can also affect the eyes. Normally, the immune system fights off foreign invaders such as a virus or bacteria. People with lupus, however, have an immune system that functions abnormally by attacking healthy tissue.
People with lupus often have times of severe flare-ups and remissions. During a flare-up, inflammation and swelling occur in the body, creating fatigue, pain, and tissue damage. The eyes are also a target of the disease. Below are five common eye problems often associated with lupus.
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How Is The Kidney Biopsy Analyzed And How Does It Affect Lupus Treatment
The pathologists in Yale Medicines renal pathology lab use advanced techniques and technology, including immunofluorescence and electron microscopy , to study the kidney tissue samples of patients with lupus nephritis.
We are looking for some very specific findings, such as crescent-shaped cell proliferation and inflammation of the small and large vessels, which is a sign of vascular involvement, Dr. Moeckel
The findings are then given a designated type and activity grade that reflects how aggressively the disease has attacked the kidney. The accurate type and grade is conveyed to the clinician, who then uses this information to determine how to treat a particular patients lupus-related kidney disease.
How Can I Work With My Doctor To Monitor My Kidney Health After A Transplant
Its important to continue following up with your nephrologist to monitor kidney function, even after a transplant. While one healthy kidney can do the work the body needs, close follow-up with a nephrologist is important to monitor any changes that might occur. Your nephrologist will monitor your blood pressure, any signs of protein in the urine, and how well your kidney filter fluids. You will want to tell your nephrologist if you notice any changes, including: swelling in your legs, increased blood pressure, or changes to your urine .
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How Is Kidney Lupus Monitored
As you return to your doctors office, she/he will most likely keep close watch on your kidneys to ensure that your kidney involvement is not worsening. There is no all-encompassing test for kidney function instead, your doctor will use a number of tests to monitor your blood and urine. By obtaining a blood urea nitrogen levels and blood creatinine levels, she/he can monitor how well your kidneys are filtering blood. In addition, you blood pressure will be monitored, since high blood pressure is an indication of kidney degeneration. High levels of protein in the urine can indicate increased kidney involvement, since protein usually does not cross from your blood vessels into your kidney tubules and thus should not appear in your urine. In addition, tests of blood complement and anti-DNA antibodies can suggest inflammation that may be affecting the kidneys.
How Is Kidney Failure Caused By Lupus Treated
Kidney disease in lupus can be treated with immunosuppressant drugs, but these may have to be taken for many years. Kidney failure caused by lupus can be treated with dialysis or, in some cases, kidney transplantation. What is lupus? Lupus, also called systemic lupus erythematosus , is a disease that can affect all parts of the body.
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What Is The Recovery Process Like For The Donor And The Person Receiving The Kidney How Long Is The Recovery Process
Typically, it takes about 4-6 weeks to recover from a kidney transplant operation. Both the donor and the person who receives the kidney should pay attention to any signs of infection or pain. The person receiving the new kidney will need close follow-up and medication and will be closely monitored by the healthcare team to evaluate the bodys response to its new organ. Follow up appointments are important in the first weeks and months after receiving a new organ. These visits may include bloodwork, frequent visits to the transplant center or adjustments to medications.
Is A Family Member Always A Match
Family members can be a match, but a good match isnt just in the DNA. Its also about blood typing and finding any antigens that might not be compatible to the receiving person. Though there is a higher likelihood of good match from a sibling, many people have successful matches from non-related donors.
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What Risks Are There For The Donor How Safe Is It
After being considered a match and scheduling the transplant, the donor needs to discuss the plan with the transplant team and what to expect post-op. While each facility is different, most can expect to stay in the hospital for 3-7 days and will need to regularly check in with their health care provider to monitor the health of their kidneys. They can continue to lead normal lives but need to be mindful of sports or lifestyles that would put their kidney at risk. However, we know from years of doing transplants that giving one kidney results in very little risk to the patient if they have no evidence of kidney disease themselves, or conditions like diabetes that could cause kidney disease.
How Does Lupus Affect Your Kidneys
Lupus is a chronic autoimmune disease that is affecting 1.5 to 2 million Americans. Its dangerous and can attack various parts of the human body, including the kidneys. When lupus affects the kidneys, it can lead to kidney failure and even become fatal. Here is what you need to know about lupus kidney and how to deal with it.
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If An Individual Is Put On A List For A Transplant How Long Could The Wait Be And How Are People Prioritized On The List
People waiting for an organ on a donor list are prioritized based on disease process, need and expected outcome. Each time a kidney becomes available, it is checked with those on the list to make sure a good match is made. So even if someone is high on the list, they may be skipped over if the kidney isnt compatible. The wait on a donor list can be anywhere from months to years. A living donor with a perfect match can shorten this waiting period considerably. Having a family member or friend who is a perfect match means you can move forward with preparations and can avoid a donation list. Often, blood type also influences how much time a person must wait for a match.
How Does Systemic Lupus Erythematosus Affect The Kidneys
This leaflet gives general information about systemic lupus erythematosus , what it is, common symptoms, treatments and how it can affect the kidneys. If you want any more information please ask your doctor. What is lupus? SLE, also known as lupus, is a long-term condition that causes inflammation in various parts of the body.
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How Is Lupus Treated
Lupus is treated with drugs that block your body’s immune system. These include drugs like steroids and antimalarial drugs. Everyone is different and your doctor will make a treatment plan that is right for you. This may include a combination of therapies. Usually treatment for lupus nephritis includes:
- Diet change
Corticosteroids and immunosuppressive drugs: These medicines are used to calm your immune system and stop it from attacking your glomeruli.
ACE inhibitors and ARBs: These are blood pressure medicines used to reduce protein loss in the urine and control blood pressure.
Monoclonal antibodies: These are man-made proteins that act like antibodies and target only one type of substance in the body.
Diuretics: These medicines help your body get rid of excess fluid and swelling. These can be used to lower your blood pressure too.
Diet changes: Some diet changes may be needed, such as reducing salt and protein in your food choices to help control blood pressure and lighten the load of wastes on the kidneys.
What Role Does A Pathologist Play In Diagnosing And Managing Lupus
Lupus has a wide range of symptoms, many of which mimic other conditions. As with other autoimmune diseases, diagnosis can be tricky.
The clinician can look at a patients symptoms and laboratory tests and say, I think this patient has lupus nephritis, but the kidney biopsy, which is the definitive test, is done in the pathology department, Dr. Moeckel says.
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Symptoms Of Kidney Involvement In Lupus
There is usually no pain associated with kidney disease, although some patients may notice swelling in their ankles. Most often, the only indication of kidney disease is an abnormal urine or blood test, so it is important to do these tests regularly, even if you are feeling well.
Warning signs include:
- Large amounts of protein in the urine getting up to urinate during the night can be a sign of excessive protein loss
- The presence of casts in the urine they can be seen under a microscope
- Red blood cells in the urine
- White blood cells in the urine
- Low blood protein
Signs or symptoms of kidney disease that can be confused with lupus nephritis may be caused by some of the drugs used to treat lupus. These problems usually stop when the medications are discontinued. Two medications that can cause fluid retention or loss of kidney function are salicylate compounds and non-steroidal anti-inflammatory drugs .
What Happens If My Kidneys Fail
If your kidneys fail, you can be treated with dialysis or a kidney transplant. Lupus patients do as well with these treatments as people who have other types of kidney disease.
Many patients with lupus nephritis have received a kidney transplant. The drugs used to prevent your body from rejecting the new kidney are the same or similar to those used to treat lupus. It is unusual for lupus to come back in the new kidney. Lupus patients with new kidneys do as well as any other patients with transplanted kidneys.
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If Someone Has Kidney Failure Do They Need To Be On Dialysis Before A Transplant
No, sometimes a transplant can prevent someone from needing to spend years on dialysis. However, some patients may receive dialysis prior to receiving their organ. In patients with living donors, we often try to do a transplant before dialysis is needed to prevent ever going on dialysis. That is not always possible, depending on the disease, how ill the patient is, how available the donor is, and timing.
Find Out If You Have Lupus Nephritis
Since lupus nephritis may not cause symptoms at first, its important that people with lupus get tested for kidney problems. Your doctor or a special doctor called a nephrologist can find out if you have lupus nephritis or other problems in your urinary system.
You may need different kinds of tests, including:
- Urine tests to check for blood and protein in your urine
- Blood tests to check how well your kidneys are filtering waste out of your blood
- Kidney biopsy to check for inflammation and scarring in your kidney tissue
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Lupus Nephritis Symptoms And Treatment
If you’ve been diagnosed with lupus, you’ll want to learn the signs and symptoms of a form of the disease called lupus nephritis that affects the kidneys. Lupus nephritis occurs in up to 60% of people with lupus. Among people who have lupus nephritis, 10 to 30% develop kidney failure, so it’s important that you are aware of the signs and symptoms.
How Common Is It For Lupus To Affect The Kidneys
Lupus mostly impacts women ages 15-44 and lupus nephritis is more prevalent and often more severe in African Americans and Hispanics than in Caucasians. Studies have shown that minority women who develop lupus at a younger age tend to have more serious complications. Up to 60 percent of people with lupus will develop kidney complications. Women of color are especially at risk.
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How Might Lupus Affect The Kidneys
Lupus can affect the kidneys in several ways. Most people are unaware of this and we therefore need to test the urine for the presence of protein that shouldnt be there. We also test the blood for abnormal kidney function.
The most common finding is protein in the urine, which is due to leakiness in the kidney caused by inflammation. If the protein in the urine is very high, in order of several grams a day, it can lead to a drop of protein levels in your blood.
It causes you to develop swelling in your ankles and legs when standing and moving, as well as developing a puffy face. Inflammation of the kidneys is generally called lupus nephritis and in different patients we have specific ways of diagnosing it depending on the individuals symptoms.
Treatment Of Lupus Nephritis
Lupus nephritis is typically treated by managing its symptoms through medication and diet. Treatment focuses on reducing inflammation and treating the underlying cause of lupus. Some patients may require treatment to restore normal kidney function, and reduce the risk of permanent damage. Treatment includes the following:
- Limiting salt and protein in the diet
- Taking medication to control high blood pressure
- Taking immunosuppresive medication
- Taking anti-inflammatory medication
In some cases, dialysis may be needed temporarily to provide adequate kidney function. Severe cases may require a kidney transplant.
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What Exactly Is Dialysis
Dialysis is the process of an external machine doing the work of the kidney that is, filtering waste products from the blood and excess fluids from the body.
During dialysis, blood is removed from the body by the pumps on a machine, passed through an artificial kidney, and returned to the body with fewer waste products. Over a few hours, the artificial kidney removes a lot of waste, which allows the patient to be well until the next dialysis session. Dialysis occurs an average of 3 times per week for hemodialysis, or every day for peritoneal dialysis.
What Resources Are Available That Can Help People Cope With Having Lupus Nephritis
A lupus diagnosis can come as a shock to many people. It is a disease that many people do not know much about. Getting the right diagnosis is the first step to getting the care you need. Because lupus is a lifelong disease, it can impact your daily routine in different ways for the rest of your life. Physical symptoms, frequent doctor visits, and financial stress can all impact your emotional well-being. Your mental health is just as important as your physical health if you are living with lupus or lupus nephritis.
Find healthy ways to copeIt is normal to have stress, anxiety and depression when facing difficult situations. If you notice changes to your mental health, these activities may help you feel better:
- Engage in positive self-talk
- Spend more time outdoors in the sun
- Explore creative activities
- Get enough sleep
- Tap into your faith
Talk to a professionalIf you want to talk to a professional, ask a member of your treatment team for a referral to a mental health therapist, counselor, or a social worker.
These professionals are trained to help you:
- Understand and process your emotions
- Improve your coping skills
- Maintain healthy relationships with loved ones
- Navigate everyday life with chronic disease
- Advocate for your needs
Many health insurance providers cover mental health services. Call your health insurance provider to find out what your health insurance plan includes and get a list of in-network mental health providers in your area.
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Lifestyle Changes For Lupus Nephritis
Certain lifestyle habits can help protect the kidneys. People with lupus nephritis should do the following:
- Drink enough fluids to stay well hydrated.
- Eat a low-sodium diet, especially if hypertension is an issue.
- Avoid smoking and drinking alcohol.
- Exercise regularly.
- Maintain a healthy blood pressure.
- Limit cholesterol.
- Avoid medications that can affect the kidneys, such as nonsteroidal anti-inflammatory drugs .
Your doctor may also recommend that you eat a diet low in potassium, phosphorus, and protein if there is already loss of kidney function.
Although lupus nephritis is a serious problem, most people who receive treatment do not go on to have kidney failure.
What Are The Symptoms Of Lupus
The most common symptoms include:
- A rash on your face
- Sun sensitivity
- Joint pain, in the small joints of the hands and feet which is worse in morning
- Hair loss in patches or in large amounts in some people
- In some cases, there can be pain when breathing
- Feeling overwhelmingly tired, which is not often realised to be part of something bigger
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