About one third of the 1.5 million Americans with lupus will develop kidney disease at the time they’re diagnosed, and another 25 percent will develop it in the first ten years after diagnosis. The American College of Rheumatology recently issued new guidelines to help doctors diagnose and treat lupus nephritis and improve patients’ lives.
Lupus affects not only the skin, but the internal organs as well, notably the kidneys. Most lupus patients develop kidney disease, a condition called lupus nephritis, and it can significantly lower chances of survival, particularly in African-American men. There is no known way to prevent kidney damage, though flares can be minimized Medical treatment can help slow or even stop kidney failure from deteriorating once it has been detected.
The ACR’s guidelines were developed after reviewing nearly half a century of research on kidney failure due to lupus. Recommendations include diagnostic testing for vascular disease in nephritis patients, aggressively treating kidney problems in pregnant women, and the use of blood pressure medication in lupus patients with signs of protein in urine. Although lupus can raise blood pressure, certain hypertension drugs also have a protective effect on the kidneys that can help lessen the severity of and danger from lupus nephritis.
The organization also recommended biopsies for previously untreated patients with nephritis. That means doctors are encouraged to study tissue samples in patients who have kidney disease to help determine the proper course of treatment.
Incidence of end-stage renal disease due to lupus has been on the rise over the past 30 years. Doctors aren’t sure what is behind this, but it is hoped that the new guidelines will help reverse the trend.
It is particularly important for patients with lupus nephritis to pay attention to heart health. That means no smoking, watching LDL cholesterol levels, eating right, and getting proper exercise.
If you have foamy or bloody urine, swelling, or signs of high blood pressure, contact a healthcare professional. Doctors can test for signs of lupus nephritis or other conditions and help you get proper treatment.