Lupus nephritis
Key points
- Lupus nephritis is a kidney disorder that is a complication of systemic lupus erythematosus, characterized by damage to the glomerulus and progressive loss of kidney function.
- Lupus nephritis is one complication of systemic lupus erythematosus (SLE).
- Signs and tests Examination indicates decreased kidney functioning with edema and may indicate renal failure.
- It is usually worse with diffuse proliferative lupus nephritis (one specific form of the disorder).
Alternative names
Nephritis - lupus; Lupus glomerular disease
Definition
Lupus nephritis is a kidney disorder that is a complication of systemic lupus erythematosus, characterized by damage to the glomerulus and progressive loss of kidney function.
Causes, incidence, and risk factors
Lupus nephritis is one complication of systemic lupus erythematosus (SLE). It is related to the autoimmune process of lupus, where the immune system produces antibodies (antinuclear antibody and others) against body components. Complexes of these antibodies and complement accumulate in the kidneys and result in an inflammatory response.
Lupus causes various disorders of the internal structures of the kidney, including interstitial nephritis, mesangial GN, membranous GN, membranoproliferative GN, diffuse proliferative GN, and others.
It often causes nephrotic syndrome (excessive protein excretion) and may progress rapidly to renal failure. There is progressive azotemia (the accumulation of nitrogenous waste products in the bloodstream) and urinary abnormalities including protein and blood in the urine.
Lupus nephritis affects approximately 3 out of 10,000 people. Systemic lupus erythematosus is most common in women, especially those 20 to 40 years old. It has a familial tendency, with a higher incidence in blacks. It may be related to other autoimmune disorders including rheumatoid arthritis and scleroderma. It has been known to be triggered by pregnancy in some cases.
In children with SLE, about half will have some form or degree of kidney involvement.
Symptoms
- Blood in the urine
- Foamy appearance to urine
- Swelling of any area of the body
- Elevated blood pressure
Symptoms of SLE may include the following:
- Joint pain
- Joint swelling
- Joint redness
- Rash
o commonly on the face but may occur on other areas
o characteristic "butterfly" distribution - Chest pain, sharp and stabbing
- Cough
- Sun sensitivity
o fever may develop after exposure to sun
o rash may develop after exposure to sun - Fatigue
- Mouth ulcers (painless)
Written and revised by
David Cohen, M.D.
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