What you should know about kidney disease and lupus
Studies have shown that approximately one third of patients with systemic lupus erythematosus SLE may develop a kidney disease known as lupus nephritis or lupus nephritis glomerulonephritis.Lupus generally shows very few signs. It does not cause pain or burning when urinating and painless in the abdomen or back.The first symptom of the patient with lupus nephritis experiences usually pockets in the legs, ankles or fingers. This is due to loss protein in the urine can lead to fluid retention to weight gain and swelling.
Sometimes, the fact that a patient has lupus nephritis is only after analysis of urine were made. It is very possible that he is doing another urine test, urinary abnormalities disappear. However, there patients whose test results in studies of abnormal urine may persist or worsen over time. These patients need more studies to determine the best treatment for combat disease because it appears that the risk of loss of renal function.
Importantly, patients with lupus may experience some symptoms that are confused and think they have this disease. For example, urinary tract infections, burning urination, or drugs used to treat lupus may produce signals that can initiate the confusion.There some evidence that can be done to determine whether a patient has lupus renal disease.
Urine is the most used and most simple test to do. A urine sample is examined to determine if there are proteins and blood cells that are not normally found in the urine.If in the urine sample is red blood cell models white (protein excretion in the urine or blood cells that accumulate within the tubules of the kidney), or who has discovered the presence of protein, the possibility of lupus nephritis, and other tests are necessary.Sometimes, which takes place in a urine sample within 24 hours to measure the ability of the kidneys to filter waste.
The blood tests also can be done, and we can mention the rate of urea nitrogen and serum creatinine. These are tests being made to see if the wastes are eliminated by the kidneys and accumulate in the serum albumin blood.By extent, one can determine whether a low protein in the blood, and chemical studies, such as sodium, serum potassium and bicarbonate to identify imbalances of salt and water in the blood.There can also be blood tests to determine if there are abnormalities of the immune system.
An IVP or sonogram can be done to determine the size and shape of the kidneys. As Overall, this test is performed before a kidney biopsy.The and takes place in a biopsy to confirm the diagnosis of lupus nephritis. This is done by inserting a needle through the skin back and remove a small piece of kidney.Then, making the game of the kidney is examined under a microscope to determine the amount of inflammation or damage permanently present in the kidney.
There are four common types of nephritis: focal or diffuse glomerulonephritis proliferative nephritis, mesangial nephritis and membranous.
The treatment of lupus nephritis must be individualized because patients are different with different needs. It is important that all factors seem to take into account when choosing treatment.General early medical treatment of hypertensive kidney disease are to control blood pressure, diuretics help remove excess fluid, changes in diet to control the consumption of salt, protein and calories. Are very important in lupus nephritis.
Corticosteroids are often used to treat lupus nephritis. We mention here the prednisolone, prednisone and methylprednisolone. There are still some unanswered questions about steroids and how they can be used more effectively. Regular, high doses of corticosteroids are given to better visualize lupus nephritis. Then the dose is reduced, but he made a careful review by the physician to make sure no nephritis worse.If corticosteroids administered for prolonged periods, can side effects appear, such as bruises, increased appetite and water retention with weight gain, cataracts, thinning hair, increased risk of infection, diabetes and others.
When patients do not respond to corticosteroids, given cytotoxic or immunosuppressive such as azathioprine or cyclophosphamide. The effect of these drugs to block the function of the immune system.As a result, other kidney damage is prevented. However, although these drugs may be beneficial, too can lead to serious complications.
Although there is an appropriate treatment, patients who develop a progressive loss of renal function and kidney failure. This requires the use of artificial dialysis, which can be done by hemodialysis or peritoneal dialysis.Also, you can do a kidney transplant, and we know it was a great success patients with lupus nephritis renal failure.
Over the years, scientific progress in understanding the causes of lupus nephritis, and there were improvements on how to treat patients.
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Kidney Disease and Hypertension, Dr. MFaulkner2
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