LUPUS NEPHRITIS
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WHAT IS LUPUS?
Systemic Lupus Erythematosus, often referred to as lupus, is a disease of the immune (natural defence) system that can affect many parts of the body, including the skin, joints, kidneys, lungs, and brain. It can range from a mild skin rash to a serious life‐threatening disease. WHAT CAUSES LUPUS?
Lupus is an auto‐immune disease. This means that your body’s natural defence system starts attacking your own healthy tissues. The immune system protects the body against infections by producing antibodies. With lupus, the immune system does not work properly and makes antibodies against your own tissues, which are called ’auto‐antibodies’. No one knows exactly what causes lupus. A number of factors, such as family history, infections, viruses, sunlight, stress and hormones, acting together could be the cause, however more research is needed. WHO IS AT RISK OF LUPUS?
Lupus affects almost 10 times as many women as men. It can occur at any age but usually starts between the ages of 15 and 44. There is a genetic (family history) link, but even if you have a close relative (parent or sibling) with lupus, the risk of developing the disease is less than 10%. WHAT ARE THE SYMPTOMS OF LUPUS?
Lupus is sometimes called ‘the great imitator’ as the symptoms are seen in many other diseases,which can make the diagnosis difficult. The symptoms of lupus can vary and include:  skin rashes particularly in areas exposed to the sun, such as the face  joint pains  mouth ulcers  hair loss  recurrent chest pains  fevers  feeling generally unwell Less common symptoms include blood clots, seizures, strokes and abnormal mood. HOW IS LUPUS DIAGNOSED?
A doctor will diagnose lupus through a history of your symptoms, a medical examination, and blood and urine tests. A blood test can detect the presence of auto‐antibodies and other problems of the immune system. No one single test can detect lupus. Lupus Nephritis Page 2/3 WHAT IS LUPUS NEPHRITIS?
Each kidney contains up to one million nephrons, the filtering units of the kidneys. Inside a nephron is a tiny set of looping blood vessels called the glomerulus. Lupus nephritis means there is inflammation of the kidney, which can result in kidney damage. Kidney damage in lupus can be mild or severe. The body’s immune system attacks the filters of the kidneys causing swelling and scarring. Lupus nephritis is seen in almost half of all people with lupus. WHAT ARE THE SYMPTOMS OF LUPUS NEPHRITIS?
Many people with lupus nephritis do not have specific symptoms, they just feel generally unwell. Sometimes lupus nephritis can cause fluid retention with swelling of the ankles, fingers, fullness around the eyes, and occasionally fluid in the lungs causing some difficulties in breathing. Some people have headaches due to high blood pressure and may see blood in their urine. HOW IS LUPUS NEPHRITIS
DIAGNOSED?
If lupus affects the kidneys then there is usually blood and protein in the urine. A blood test will measure the auto‐
antibodies and also the level of the kidney function to make sure there is no damage. You will also need a urine test to check for protein and blood. You may need a kidney biopsy. A kidney biopsy collects a tissue sample that is looked at under a microscope. This will confirm the diagnosis of lupus nephritis, and find out how active the disease is and what treatment is required. HOW IS LUPUS NEPHRITIS TREATED?
Treatment depends on the level of damage to your kidneys. In more severe cases, treatment involves medications that block your immune system. Some of these medications are corticosteroids, azathioprine, mycophenolate mofetil and mycophenolate sodium. Sometimes you may need to have medication administered via vein, such as cyclophosphamide or rituximab. The kidney biopsy helps to determine what the most suitable medication is and for how long the treatment should last. You may also need to take tablets to control your blood pressure and reduce the loss of protein from your kidneys. Lupus commonly responds well to treatment. WHAT IS THE LONG-TERM OUTLOOK FOR LUPUS
NEPHRITIS?
Lupus nephritis can range from mild to life‐threatening, but most people with lupus nephritis do respond to treatment. Fortunately, it is rare for lupus nephritis to cause significant kidney damage that would require dialysis or kidney transplantation. Lupus Nephritis Page 3/3 WHAT CAN I DO TO LOOK AFTER MYSELF?
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Work with your health care team to receive the right treatment and advice Have an active role in your treatment Protect yourself from the sun Make moderate physical activity a habit, be a non‐smoker, maintain a healthy diet, and reduce your stress levels It is not unusual to feel scared, frustrated, sad or angry. Acknowledge your feelings and find support if you find they are affecting your daily life For more information about Kidney or Urinary health, please contact our free call Kidney Health Information Service (KHIS) on 1800 454 363. Alternatively, you may wish to email [email protected] or visit our website www.kidney.org.au to access free health literature. This is intended as a general introduction to this topic and is not meant to substitute for your doctor's or Health Professional's advice. All care is taken to ensure that the information is relevant to the reader and applicable to each state in Australia. It should be noted that Kidney Health Australia recognises that each person's experience is individual and that variations do occur in treatment and management due to personal circumstances, the health professional and the state one lives in. Should you require further information always consult your doctor or health professional. Kidney Health Australia gratefully acknowledges the valuable contribution of Dr Fiona Brown in the development of this material. Revised July 2015 If you have a hearing or speech impairment, contact the National Relay Service on 1800 555 677 or www.relayservice.com.au. For all types of services ask for 1800 454 363.