Systemic lupus erythematosus (SLE), often referred to as lupus, is a persistent inflammatory disorder. This condition prompts the immune system to launch attacks on various body systems, encompassing the skin, heart, lungs, joints, nervous system, blood vessels, and kidneys. Its “systemic” nature means it can impact the entire body.
In the case of autoimmune diseases like lupus, antibodies lose their ability to function correctly. In lupus, these antibodies struggle to distinguish between harmful foreign substances and the body’s own healthy cells and tissues. Consequently, the immune system turns against its own organs, resulting in varying levels of inflammation and organ damage.
Severe lupus can affect multiple organs, with the kidneys being the most frequently affected. The exact cause of lupus remains elusive, but it is believed to have connections to both hereditary and environmental factors. Lupus predominantly affects women during their childbearing years and is more prevalent among minority groups. Approximately 90 percent of lupus cases occur in women, particularly in African Americans, Latinos, Asians, and Native Americans.
While the term “lupus” generally refers to SLE, there are two milder variants of the disease:
Discoid (Cutaneous) Lupus
Primarily impacting the skin but potentially extending to hair and mucous membranes, discoid lupus manifests as a rash on the face, neck, or scalp. This rash can persist for varying durations and may recur.
Drug-Induced Lupus
Certain prescribed medications, such as hydralazine and procainamide, can trigger drug-induced lupus, which usually subsides when the medication is discontinued. This variant is more common in men, but only a small percentage of individuals taking these drugs develop lupus.
Symptoms of lupus vary among individuals, but common indicators include:
The kidneys are particularly vulnerable in lupus patients. Inflammation of varying severity can lead to lupus nephritis and potential kidney failure. Lupus nephritis refers to kidney disease in SLE patients, characterized by damage to the tiny kidney filters, resulting in reduced kidney function. This can lead to symptoms like edema (swelling and weight gain), but few other signs. Lupus nephritis typically doesn’t cause abdominal or back pain or painful urination.
It’s crucial to note that not all kidney issues in lupus patients stem from lupus nephritis; urinary tract infections are also common and require antibiotic treatment. Additionally, some medications used for treating lupus can produce kidney-related symptoms, which usually resolve upon discontinuation.
Treatment approaches for lupus depend on disease severity and the organs affected. Medications, both prescription and over-the-counter, can reduce swelling, lower blood pressure, and control inflammation by suppressing the immune system. Dietary adjustments, including limiting protein, sodium, and potassium intake, may be necessary, along with maintaining a balanced diet. Lifestyle changes, such as sun protection, stress management, sufficient sleep, and regular exercise, play a significant role in managing lupus. Support groups and counseling can help alleviate stress, while avoiding smoking and alcohol is advised. Regular medical checkups are essential.
Despite appropriate treatment, some lupus nephritis patients may develop kidney disease requiring dialysis or a kidney transplant as potential treatments.
