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What Are the Different Types of Lupus Nephritis Treatment?

Jacquelyn Gilchrist
Jacquelyn Gilchrist

Lupus nephritis treatment will vary, depending on the specific needs and the condition of the patient. Medications are usually used, and some doctors may also recommend plasmapheresis, which is a blood filtering procedure. Lupus nephritis refers to a kidney disease that is caused by lupus, an autoimmune disorder. It can result in impaired kidney function or kidney failure, as well as bloody urine and kidney inflammation.

Not every patient will be able to undergo certain lupus nephritis treatment methods. For example, women who wish to become pregnant in the future will be unable to use certain drugs that can damage the ovaries. Patients with other medical conditions that affect the kidneys will also need to undergo treatment to correct those problems. Those with high blood pressure will likely take additional medicines to control this condition. Some patients will also be instructed to consume specific amounts of protein, salt, and potassium, as well as overall calories, because changes in diet can help to slow the progression of the disease.

In some cases, patients who have lupus nephritis respond well to corticosteroids such as prednisone.
In some cases, patients who have lupus nephritis respond well to corticosteroids such as prednisone.

In order to determine the correct type of lupus nephritis treatment for the patient, the doctor will perform a number of tests. He will check for protein or blood in the patient's urine, because this indicates damage to the kidneys. The patient will also have a blood test to check for urea and creatinine, because high levels of these substances indicates that his kidney function is becoming impaired. A kidney biopsy is also typically required, because examining a small sample of kidney tissue will inform the doctor if the disease is advanced.

Swollen legs and feet may be symptoms of lupus nephritis, a form of renal parenchymal disease.
Swollen legs and feet may be symptoms of lupus nephritis, a form of renal parenchymal disease.

While there is no cure for lupus nephritis, some drugs may help to slow the progression of the disease and retain kidney function. Other medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may adversely affect the function of the kidneys, and these should be avoided. Patients who have edema, or swelling caused by water retention, can benefit from diuretic drugs, which remove excess fluid.

If untreated, lupus nephritis can cause bloody urine.
If untreated, lupus nephritis can cause bloody urine.

Doctors often prescribe corticosteroids for lupus nephritis treatment, particularly if the disease is not yet advanced. These drugs, which include prednisone, reduce the body's inflammatory response to the autoimmune disorder. They can also cause serious side effects, particularly when used for a long time or in high doses. Patients should be aware that corticosteroids may increase the risk of osteoporosis, cataracts, and infections. Those who use corticosteroids for lupus nephritis treatment will likely be prescribed calcium supplements to help reduce the risk of osteoporosis.

Immunosuppressant drugs may also be used to slow the progression of lupus nephritis. These drugs include azathioprine, cyclophosphamide, and mycophenolate mofetil. Doctors may recommend these drugs if the patient has a poor response to corticosteroids, if he experiences severe side effects from steroids, or if he has severe renal lesions.

Plasmapheresis is another option for lupus nephritis treatment. For this non-invasive procedure, the patient is connected to a machine that filters the blood. Some of the patient's blood is drawn toward the machine through a catheter in one arm, and it returns intravenously to the other arm after it is filtered. During the filtering process, the plasma, or liquid, part of the blood is removed. Sterile saline solution is used to replace the plasma, along with immunoglobulin, which is a solution of healthy antibodies that can help treat autoimmune disorders.

Discussion Comments

turquoise

@donasmrs-- I agree with the other comment. Treatment depends on how far the disease has gotten and how quickly it is developing. Level I and II lupus nephritis can be treated with corticosteroids. But level III and IV require other treatments like anti-cancer drugs, immunosuppressants and plasmapheresis.

Unfortunatey, lupus nephritis usually leads to other complications like high blood pressure as the article said. So diet changes and medications to keep these under control become necessary as well. It's not uncommon for someone with advanced lupus nephritis to be on four or five different drugs at the same time.

candyquilt

@donasmrs-- Yes. My sister has lupus nephritis and one of the medications that she's using is an anti-malarial drug. She's also using a corticosteroid and an immunosuppressant. I have no idea if every patient with kidney disease/inflammation due to lupus can use it though. It probably depends on how advanced the disease is. It's a good idea to ask a doctor knowledgeable in lupus about this.

Lupus can present itself differently in different people. So even though treatment options apply to everyone, every person does not need the same exact treatment. It has to be considered on an individual basis so please speak to an expert about it.

donasmrs

I know that anti-malarial drugs can be used for lupus but are anti-malarial medications safe for those with lupus nephritis?

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    • In some cases, patients who have lupus nephritis respond well to corticosteroids such as prednisone.
      By: Thirteen Of Clubs
      In some cases, patients who have lupus nephritis respond well to corticosteroids such as prednisone.
    • Swollen legs and feet may be symptoms of lupus nephritis, a form of renal parenchymal disease.
      By: Ocskay Bence
      Swollen legs and feet may be symptoms of lupus nephritis, a form of renal parenchymal disease.
    • If untreated, lupus nephritis can cause bloody urine.
      By: tomschoumakers
      If untreated, lupus nephritis can cause bloody urine.