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.
In The Event Of Kidney Failure:
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.
Learn more about Lupus Nephritis >
Disclaimer: The UCLA Health System cannot guarantee the accuracy of such information. The information is provided without warranty or guarantee of any kind. Please speak to your Physician before making any changes.
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.
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Skin Rashes And Lesions
While many people often associate lupus with the facial butterfly rash, the reality is lupus can cause a variety of skin rashes and lesions, most of which appear on sun-exposed areas like the face, ears, neck, arms and legs. According to the Lupus Foundation of America, 66 percent of people with lupus develop some sort of skin disease.
There are three main types of cutaneous lupus:
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.
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What Should I Eat If I Have Lupus Nephritis
If you have kidney disease, you may need to change what you eat. Dietitians are nutrition experts who can advise you about healthy eating and meal planning. Find a registered dietitian who can help you. Eating the right foods can help you manage your kidney disease. If you have high blood pressure, eating foods with less sodium may help you lower your blood pressure.
Other Problems In The Urinary System
In addition to lupus nephritis, lupus and lupus treatments can increase your risk for other problems in the urinary system :
- Urinary tract infections
- Lupus cystitis
The most common symptom of UTIs and lupus cystitis is peeing more often than usual. Your doctor can do tests to find out whether problems in your urinary system are caused by lupus or by a medicine youre taking to treat lupus.
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Why Is A Kidney Biopsy So Important In Managing Treatment For People With Lupus
The kidney biopsy is the gold standard for the diagnosis of lupus nephritis,” Dr. Moeckel says. Though lupus causes uncomfortable and debilitating symptoms, many people live a long time with the disease. But when the inflammation spreads to the kidneys, it is a sign that the disease is accelerating and becoming more destructive. The degree of disease activity correlates with the amount of inflammation in the kidney, Dr. Moeckel adds.
A patient with complete failure of kidney function requires dialysis, which can have its own set of complications, he says. Thats why the kidney biopsy is crucial in assessing the stage of the disease in order to treat adequately and prevent complete loss of renal function.
If lupus nephritis is suspected, doctors will order a kidney biopsy, which can be performed on an outpatient basis. Under ultrasound guidance and using local anesthesia, a biopsy is taken using a very thin needle that is inserted into the kidney tissue. The specimen is sent immediately to the pathology lab for further processing. The tissue will undergo many tests to determine the presence and extent of the immune-mediated injury by lupus.
What Are The Causes
Around six in ten people with lupus will develop kidney disease. It can be caused by antibodies, sent out to attack problems elsewhere in the body, getting stuck in the glomeruli , and then attacking them by mistake. This type of disease, characterised by damage to the glomeruli, is generally known as glomerulonephritis.
It is not clear why the immune system goes wrong. There may be some trigger, such as an infection or an adverse reaction to a drug. Certain factors can also worsen lupus, including infections, hormonal changes related to oestrogen such as periods, the combined oral contraceptive pill, pregnancy, and the menopause, having an operation, exposure to sunlight and possibly stress.
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What Tests Are Used To Diagnose Lupus Nephritis
It is really important that people with lupus have their blood pressure checked, urine dipped and kidney function measured regularly. Lupus nephritis can be entirely without symptoms and it is really important to detect as early as possible.
If we dip the urine in patients with lupus, we can often detect invisible blood, which is what we call micro blood in the urine or microhaematuria. Testing urine can be a problem in women due to their menstrual cycle and therefore we tend to see them every four weeks otherwise it is impossible to test when they have their period.
When we are making our diagnosis, we look at kidney function, whats in the urine and the degree of proteinuria, whether there are new onset changes or if the proteinuria is rising.
We would recommend a kidney biopsy to make a diagnosis. This is done under local anaesthetic and is a very quick procedure. We do this so the we can examine a tiny piece of kidney under a microscope and check for inflammation.
What Tests Are Done To Find Out If I Have Lupus Nephritis
Your doctor will do a physical examination, get your medical history, and do special tests. These tests include:
- Urine test to check for protein and blood
- Blood tests
- Check your levels of protein and cholesterol
- Check your eGFR to show how well your kidneys are filtering wastes
- Check for antiphospholipid antibodies and anti-nuclear antibodies at least once during your disease.
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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
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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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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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.
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What Are The Signs Of Kidney Lupus How Is It Diagnosed And Classified
Swelling of the ankles and abdomen may be a sign of kidney disease, but the problem with kidney lupus is that often people are not aware that it is occurring until they visit the doctor for lab tests and blood work. Testing for the disease includes urinalysis, which your doctor will check for items such as red blood cells, red blood cell casts, and protein that has leaked from your kidneys into your urine. In addition, she/he will most likely ask you to perform a 24-hour urine test and determine the efficiency with which your kidneys are filtering blood by measuring your creatinine clearance. Lastly, your doctor may also recommend you to a kidney doctor to perform a biopsy to determine the class and degree of your kidney involvement. There are 6 levels of kidney lupus and the class in which your disease falls will help your doctor to design a specific course of treatment.
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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Do These Treatments Have Side Effects
You should always speak with your doctor about the risks and benefits of any of the treatments you receive. Each of the drugs during any of these treatments can have their own side effects. Fortunately, these side effects usually are manageable for most patients. Discuss your treatment with your healthcare provider. Your overall health and the health of your kidneys should always be considered. There are times when the side effects of certain treatments are not worth the risk to your health.
If you are a woman with lupus nephritis and want to have children, you should discuss with your healthcare provider the effect your treatment may have on that process. There are ways to make sure that treatment is less harmful to this process.
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.
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What Is The Cause Of Lupus
To date, the cause of lupus is unknown however it has been linked to heredity and environmental factors.
Who are people at risk of developing lupus?
Lupus targets around 90 percent of women in their childbearing years. It also occurs more often in minorities, particularly African Americans, Latinos, Asians and Native Americans.
Lupus Nephritis Classes And Related Signs And Symptoms
Lupus nephritis is divided into 6 different stages or classes based on the results of a kidney biopsy. Your doctor will describe these as classes. Of those people diagnosed with lupus nephritis, 70% will be diagnosed as having Class 3, 4 or 5. The following table provides an overview of these different classes as well as certain signs and symptoms that may occur during various stages.
Symptoms of lupus nephritis often include weight gain swelling in the legs, feet, or ankles and urine that is foamy, bubbly, or frothy. Additional signs and symptoms associated with the different classes of lupus nephritis are noted below.
| Class |
|---|
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What Are The Complications Of Lupus Nephritis
Lupus nephritis can cause permanent kidney damage, which is called chronic kidney disease, or CKD. The most serious type of lupus nephritis, proliferative nephritis, can cause scars to form in the kidneys. These scars damage the kidneys and keep them from working the way they should. Chronic kidney disease that gets worse and causes the kidneys to stop working is called kidney failure or end-stage renal disease . Between 1 and 3 out of every 10 people with lupus nephritis eventually get kidney failure/ESRD.
People with lupus nephritis also have a higher chance of getting certain types of cancer, heart problems and blood vessel problems.
An Important Note About Medications And Blood Pressure
Due to the silent nature of kidney lupus, it is very important that you take your medications daily as prescribed by your doctor. Even if you do not feel sick, inflammation in your kidneys and other organs can lead to permanent, irreversible scarring. Your medications can combat this inflammation right now, but permanent scarring will never go away. If kidney disease is allowed to progress without treatment, your kidneys will fail, and you will need to go to dialysis three times per week to have your blood filtered. The only way to get off dialysis is to have a kidney transplant, and organ transplant opportunities are not easy to come by. This information is not meant to frighten you, but merely to ensure that you understand how important it is to take your medications!
In addition, since the kidneys are tied intimately to the regulation of your blood pressure, it is imperative that you maintain a healthy blood pressure of 120/80 mmHg. If your doctor prescribes a blood pressure medication to keep your kidney lupus in check, be sure to take it exactly as prescribed. Limit your intake of salt to less than 3 grams per day, and try to eat a healthy, well-balanced diet. The prognosis for people with lupus nephritis does not have to be grim it is important to remember that you play the most important role in keeping your body as healthy as possible!
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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.
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Why Does The Immune System Go Wrong
Several genetic factors probably influence the development of SLE.
Some genes in the body help the immune system to function. In people with SLE, changes in these genes may stop the immune system from working properly.
One possible theory relates to cell death, a natural process that occurs as the body renews its cells, according to Genetics Home Reference.
Some scientists believe that, due to genetic factors, the body does not get rid of cells that have died.
These dead cells that remain may release substances that cause the immune system to malfunction.
Lupus may develop in response to a number of factors. These may be hormonal, genetic, environmental, or a combination of these.
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