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Lupus Nephritis is a complication of SLE (Systemic Lupus Erythematosus) which is an autoimmune illness and may cause damages on different parts of our body like heart, skin and bone and so on. Lupus Nephritis is the major cause of death among SLE patients, so it is very important for SLE patients to pay extra attention on their kidney, so as to avoid Lupus Nephritis.
Lupus Nephritis refers to kidney problem caused by SLE, so long-term uncontrolled lupus is the cause of Lupus Nephritis. However, how is kidney affected by SLE?
SLE is an illness marked by a variety of antibodies in the blood like antinuclear antibodies, anti-single stranded DNA antibody, anti-double stranded DNA antibody and anti-histone antibody and so on. Appearance of these antibodies is due to highly reaction B cells which plays an important part in the whole immune system. These antibodies combine with autologous antigen and form immune complexes. In normal condition, immune complexes can be cleared away successfully; however, when immune system goes wrong, immune complexes will stay in blood and circulate with blood. Immune complexes may settle in many parts of our body and when they deposit in kidney, immune response will appear, which can cause kidney damages directly. Lupus Nephritis is caused when kidney damages are caused by immune response which appears due to deposition in kidney.
Since SLE is an illness that may involve many body systems like skin, bone and heart, so SLE patients always experience many symptoms like fatigue, fever, joint pain, chest pain, hair loss, dental ulcer and myalgia and so on.
Lupus Nephritis is a kidney problem caused by years of SLE, so when one is affected by Lupus Nephritis, he also has the following symptoms:
● Proteinuria which refers to presence of protein in urine. In serious cases, it appears as foamy urine or bubbly urine.
● Swelling or edema
● High blood pressure
● Frequent urination at night
● Changes in urine color: Normal urine color should be yellow with bad smell; however, for Lupus Nephritis patients, their urine may appears as tea-colored, dark-orange or red.
● Poor appetite, nausea and vomiting
● Yellow skin, dry skin and itchy skin
Medicines for Lupus Nephritis
When one is diagnosed with Lupus Nephritis, he will be prescribed with many medicines to control illness condition:
Glucocorticoid: Glucocorticoid like prednisone plays an important part in the treatment for Lupus Nephritis and it is the most commonly used drugs in medicine. By taking this kind of drugs, illness condition can be brought under control quickly, but long-term usage of this medicine will cause many side effects like weight gain, secondary high blood pressure, mental excitement, acne, gastrointestinal bleeding, osteoporosis and electrolyte disturbance and so on.
Cytotoxic drugs: Cytotoxic drugs used in the treatment for Lupus Nephritis include cyclophosphamide, cellcept, azathioprine, cyclosporine A and tacrolimus and so on. It is another type of medicine used to by Lupus Nephritis patients. They works by block immune response, which is helpful for prevent further kidney damages; however they can not solve problem fundamentally and usually when patients stop taking medicine or reduce medicine does, illness relapses. However, if they keep taking this medicine, side effects like nausea, vomiting, septicemia, hair loss, liver damages, infection and hemorrhagic cystitis will be caused.
Plasma exchange: Plasma exchange shows extremely effective treatment effects on Lupus Nephritis. It turns out with plasma exchanges, toxins that accumulate in blood due to decreased kidney function and immune complexes in the blood can be cleared away timely and successfully. This is very helpful for prevent further deposition and immune response, so it helps to prevent further kidney damages. In medicine, plasma exchange is always used together with oral medicines.
Chinese medicine: Glucocorticoid and cytotoxic drugs are the most commonly used medicine for Lupus Nephritis, but aside from them, there are some Chinese medicines that have been proven to be able to treat Lupus Nephritis. These Chinese medicines have function of anti-inflammation, anti-coagulation, dilating blood vessels and degradation. With these benefits, not only immune complexes in the blood can be removed, immune disorder can be normalized as well. More importantly, no side effects are caused during the whole treatment process.
Considering the importance of tight control of SLE and protection of residual kidney function, Lupus Nephritis need to make diet changes according to the following principles:
1. Try to eat much more high-calorie foods and high vitamin foods.
2. Go on a low-salt diet and this need them to add less salt while cooking and also stay far away from pickled foods and processed foods.
3. High quality protein like lean meat and milk is suggested, but for those who have not started dialysis, they need to limit the intake of it. However, for these Lupus Nephritis patients who are on dialysis, they need to ingest much more protein as some of the protein might be leaked out during dialysis and this may lead to hypoproteinemia.
4. Adjust potassium intake, phosphorus intake and calcium intake according to their blood test report. For instance, if blood test report shows there is high level of potassium in blood, then they need to reduce potassium intake by avoiding high-potassium foods like banana and spinach.
5. Reduce fluid intake, including soup, if they have swelling symptom.
Prognosis of Lupus Nephritis differs from case to case; but generally speaking, patients’ survival rate for 5 to 10 years is as high as 75%-85%. Besides, compared with patients who have massive proteinuria, persistent high blood pressure, and who are diagnosed with diffuse proliferative lupus nephritis, these who have a tight control about their illness usually have a better prognosis. Therefore, a prompt diagnosis and treatment is very important for Lupus Nephritis patients.