Out of all the vital organs in our body, our kidneys hold a unique status. Although they are smaller in size compared to other major organs, they perform one of the most important functions for the body – filtering out waste from our bodies. Hence, any ailment related to the kidney has to be treated carefully.

One such ailment, suffered by at least 5 million people around the world is Lupus Nephritis. Let’s deep dive into this disease and understand its nuances.

What is Lupus Nephritis?

Lupus nephritis is a kidney ailment faced by people who have systemic lupus erythematosus (or lupus in short), an autoimmune disease where the body’s immune system attacks its own cells and organs. During lupus, the immune system makes proteins called autoantibodies which attack organs and tissues in the body, including the kidneys. This condition is known as lupus nephritis.

During lupus nephritis, lupus autoantibodies affect parts of the kidneys, thus affecting its ability to filter waste. This leads to irritation and swelling of the kidneys. This can affect the functioning of the kidneys, resulting in blood and protein in the urine and high blood pressure. This condition can become serious and lead to kidney failure as well.

How is Lupus Nephritis Diagnosed?

The symptoms of lupus nephritis are often similar to other diseases, hence many people suffer from the disease for some time before receiving a formal diagnosis. There’s no single test to diagnose lupus. However, lupus nephritis is diagnosed using a combination of different methods:

• Reviewing medical history and family history: The doctor will assess symptoms and other associated problems. The doctor will also ask for a family history of lupus and other autoimmune diseases.
• Blood and urine tests: An antinuclear test (ANA) is conducted to understand whether a person’s immune system is likely to create lupus antibodies. If there’s a positive result, the doctor conducts more blood and urine tests to find antibodies specific to lupus nephritis to screen and monitor kidney dysfunction.
• Anticoagulation tests: Coagulation tests are useful to identify lupus anticoagulants. When these anticoagulants are present, the blood takes longer than normal to clot during the coagulation test. Almost half of all lupus patients have lupus anticoagulants, thus helping in the initial diagnosis of lupus.
• Kidney biopsy: This is a minor surgical method where tissue samples from the kidney are obtained and examined under a microscope to look for signs of lupus nephritis.

How is Lupus Nephritis Treated?

The doctor designs the treatment plan based on the patient’s specific conditions. The primary treatment of lupus is using drugs to block the body’s immune system. Normally, the treatment includes:

• Immunosuppressive drugs
• Corticosteroids – These medicines calm your immune system and prevent it from attacking the blood vessels in your kidney.
• Monoclonal antibodies – These are man-made proteins that act like antibodies.
• Diuretics – These are used to get rid of swelling and excess fluid. They are also used to lower blood pressure.
• ACE inhibitors and ARBs – These are blood pressure medicines which are used to reduce protein loss in the urine and control blood pressure.
• Diet change – One of the primary treatments includes changing the diet. Salt and protein restriction is primarily suggested to control blood pressure and lighten the load on the kidneys.

The key to the treatment lies in finding a healthcare provider who listens to the patient’s concerns. Sometimes patients may be referred to other specialists if other organs are affected as well.

Side effects of Treatments

Any drug during any treatment can have side effects and how it affects someone varies from person to person. It is necessary to speak to your doctor regarding the side effects and benefits of any treatment before starting it. Most side effects of lupus nephritis treatment are manageable for most patients.

Women diagnosed with lupus nephritis who want to have children need to discuss their plans with their healthcare provider so that the treatment doesn’t interfere with their pregnancy plans. There are also ways to reduce the side effects of treatment, which the doctor can assist with.

Living with Lupus Nephritis

While medication is the primary treatment of lupus nephritis, lifestyle changes can bring a world of change to managing this disease. Speak to your healthcare team for a holistic approach to living with the disease.

Follow a kidney-friendly diet

Incorporating kidney-friendly food is key to managing the disease and lowering blood pressure. Speak to a renal dietician to understand what you can eat and cannot. Here are some nutrition tips that can be helpful:

• Limit salt and sodium in your diet, especially if you have high blood pressure.
• Avoid all kinds of processed food including processed meat, sauces and others.
• Restrict your daily protein intake. Speak to your doctor to find out how much protein you can eat every day and try to stick to those limits.
• Incorporate more heart-healthy foods such as fruits and vegetables.

While these methods are useful, make sure to speak to your doctor before making any changes to your diet.

Incorporate exercise into your everyday routine

The role of exercise in our physical and emotional well-being has long been established. It can also help strengthen parts of the body that are affected by lupus nephritis. Focus on low-impact exercises such as walking and yoga to strengthen your bones and muscles. Talk to your doctor to understand what kind of exercises are allowed for you.

Focus on your mental health

The importance of mental health in managing any chronic condition is often undermined. It is okay to feel frustrated or low after receiving the diagnosis or while living with the disease. Practice techniques such as meditation that can improve your mental health and reduce stress.

Ensure to have adequate sleep

Another essential aspect of managing the disease is sleep. Get at least 7 hours of well-rested sleep to reduce stress and anxiety. You can follow sleep-inducing techniques to ensure that you get a good night’s sleep.

Lupus Nephritis – A Final Word

A diagnosis of lupus nephritis can be difficult to handle. However, it is important to know that proper treatment is the most important aspect of managing the disease and helping you live a comfortable life. Make sure to follow your doctor’s advice and recommendations as much as possible to make your life comfortable. There are a lot of resources online which can help you find practical tips and techniques for living with the disease. Minor lifestyle changes can go a long way in living a comfortable life with the disease.

Sources:

• https://www.pfizer.com/disease-and-conditions/lupus
• https://www.kidney.org/atoz/content/lupus
• https://www.mayoclinic.org/diseases-conditions/lupus-nephritis/symptoms-causes/
• https://www.allinforlupusnephritis.com/managing-lupus-nephritis