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The Impact of Lupus on the Kidneys  

Those who have lupus know all too well how the disease can impact a number of organs and systems throughout the body. The organs most frequently impacted by systemic lupus erythematosus (SLE) are the kidneys.

How kidneys function in the body

Unless you’ve had one removed, you have two kidneys under your rib cage and on either side of your body. The kidneys have one job, and it’s an important one: they filter your blood. They achieve this by balancing electrolytes, controlling fluid balance, and removing waste. All of the blood in your body passes through your kidneys multiple times a day, where the waste is converted to urine and the filtered blood is returned to the body. Many people lead healthy lives with just one kidney or with kidneys that are only partially functioning because of the millions of nephrons that are inside each of them.

If your kidneys fail, your blood must continue to be filtered and in order to do that, dialysis is necessary. Dialysis is the process of filtering your blood outside of your body when kidneys are unable to perform this task effectively inside the body. Many diseases, including lupus, can lead to kidney failure.

The impact of lupus on the kidneys

Lupus nephritis, a condition commonly occurring in patients who suffer from lupus, refers to kidney inflammation that is severe enough to reduce the kidneys’ ability to function. As a result, waste materials accumulate in the blood and excess water accumulates in the body. This is most likely to occur within 5 years of the onset of your lupus symptoms.

Signs and symptoms of lupus nephritis

When lupus nephritis first begins, it’s possible that you won’t have any symptoms at all. This is why routine monitoring by a healthcare professional, often with routine lab work, is so essential for those with lupus. As lupus nephritis worsens, the following symptoms are expected:

  • Swollen ankles, feet, face, or legs
  • Frequent urination, especially at night
  • Foamy urine
  • High blood pressure

In addition, lupus (or the medications you’re taking to manage lupus) might impact your urinary system in other ways, producing similar symptoms. Urinary tract infections (UTIs) and lupus cystitis are both risks that patients with lupus face. Both of these conditions can cause urinary frequency, pain with urination, and other related symptoms. Letting your doctor know if you experience any changes gives them the opportunity to run important tests and make decisions about your treatment plan.

Lupus nephritis during pregnancy

It can be hard to recognize the symptoms of lupus nephritis during pregnancy because the symptoms of the condition and the symptoms of pregnancy are similar. Healthy pregnant women often experience swelling, increased blood pressure, and frequent urination. For this reason, continue to work with the doctor who treats your lupus even as you work with an OBGYN to oversee your pregnancy, and report new symptoms even if you believe they’re related to pregnancy.

Preventing kidney problems

If you have lupus, there are steps you can take to reduce the likelihood of kidney damage related to lupus nephritis and other conditions:

  • Reduce your sodium intake. Ask your provider how much sodium is acceptable in your daily diet and then monitor and manage that intake.
  • Reduce your intake of saturated fats by cooking with healthy fats and checking nutrition labels.
  • Increase your protein intake by choosing more meat and dairy items in your diet.
  • Avoid alcohol. If you do choose to drink, drink only in moderation to protect your kidneys.
  • Manage other health conditions by keeping your blood pressure, blood sugars, and cholesterol levels under control.

Diagnosing lupus nephritis

Tests that can help your provider detect kidney problems include urine tests, blood tests, and a kidney biopsy. Which tests are appropriate for you will depend on a multitude of factors.

Treatment of lupus nephritis

When it comes to lupus and the kidneys, finding the right combination of medications can be a trial-and-error process. Your provider may make adjustments to your medications over the first few weeks or months until the desired outcome is achieved.

Medications most commonly used include Benlysta, steroids, Lupkynis, and immunosuppressants.

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