Lupus and Renal Failure - Lupus Nephritis

Lupus is an auto-immune disease that can affect any system in the body - organs, joints, skin. The name is apparently originally related to the facial appearance of lupus patients supposedly looking as if a person has been savaged by a wolf, as two thirds of sufferers develop some kind of skin disease. An auto-immune disease means that the body's defense mechanisms (antibodies) attack the body's own cells. It is unpredictable and potentially fatal. The side effects of a damaged immune system include potentially heart attacks, strokes, miscarriages, and organ failure. There is no cure available for lupus, so treatment tends to concentrate on relieving the side effects.

Butterfly facial rash due to Lupus.  Click to enlarge for more information

There is no specific gene that has been proved to cause lupus, but it does show a tendancy to be a hereditary disease, or affect those with family members who have other auto-immune diseases (but this does not exclude those with no family history of these diseases from contracting it). There is also a greater risk of developing lupus if your family background is African, Asian, or Hispanic. It usually appears in the age group ten to fifty. It is more likely in women than men - about nine times more likely. It has been noted that exposure to the sun, an infection or having a child are common features and triggers among sufferers. One common symptom is a facial rash on the cheeks and nose that has the appearance of a large butterfly. Rashes can occur on other parts of the body that get exposed to the sun. Although red and scaley in appearance, these rashes do not usually cause pain or itches.

One big problem is that in about 40% of adult patients and about 60% of children with lupus, the kidneys are affected or will be eventually. These problems may not cause symptoms, though some people notice swelling in their legs or ankles. Most patients only learn about their kidney trouble when a urine test reveals blood or abnormal protein levels.

Lupus nephritis is the specific disease where lupus causes inflamation of the kidneys - similar to glomerulonephritis in other words. The kidneys no longer properly remove the waste products from the blood, nor can they properly control the level of fluids in the body. The latter, as all renal failure patients know, can lead to swelling and gain of weight, with swollen feet, ankles, legs hands and / or eyelids being among the first symptoms of lupus induced kidney failure. The swelling often becomes worse throughout the day. The urine may also be foamy or frothy, or have a red color. (These are common symptoms of kidney failure, as discussed elsewhere on this site.) If patients are not treated the nephritis can lead to permanent damage, and possibly end-stage renal disease.

Lupus nephritis usually develops within the first five years after patients show signs of having lupus. Unfortunately there are few obvious symptoms in the early stages of lupus nephritis, until you see the symptoms mentioned above, at which point you will probably be told to have blood and urine tests.

Although lupus nephritis is a serious problem, effective treatments do exist and can prevent end stage renal failure occuring. Corticosteroids can be prescribed to reduce the inflammation, and immunosuppressive drugs are also given. With proper treatment, patients who develop lupus nephritis can still live a normal life-span. If you have lupus, or any of the symptoms mentioned above, do contact your doctor immediately and ask for blood and urine tests.