Can lupus nephritis lead to kidney failure?

Question

Hello doctor,

I am a 29-year-old woman who has been living with lupus for the past two years. My nephrologist now says that my kidneys are being affected by something called lupus nephritis. My urine tests show protein, and I am starting new medications.

I am worried about long-term kidney damage. Will I need dialysis someday? How can I tell if the kidney problem is getting worse? I have read that these drugs can cause side effects such as weight gain and mood changes. Is there a way to manage these effects? I want to continue working and avoid hospital stays.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

So, lupus nephritis happens when the immune system attacks the kidneys, leading to inflammation and leakage of protein into the urine. The good news is that with early and appropriate treatment, many people can avoid serious long-term damage.

Whether or not dialysis is needed in the future depends on how well your kidneys respond to treatment now. Many patients with lupus nephritis can maintain good kidney function with the right medications and monitoring. To track whether the condition is getting worse, your doctors will monitor your urine protein levels, blood pressure, kidney function tests like serum creatinine and eGFR, and sometimes repeat kidney biopsies if needed.

Medications often include steroids and immunosuppressants like Mycophenolate or Cyclophosphamide, and yes, these can come with side effects like weight gain, fluid retention, mood swings, and increased infection risk. You can help manage some of these effects by staying physically active, eating a low-sodium and balanced diet, and getting emotional support or counseling if mood symptoms become overwhelming.

Keeping blood pressure well controlled and avoiding NSAIDs (non-steroidal anti-inflammatory drugs) or anything that strains the kidneys will also protect your kidney function. The goal is to quiet the inflammation, protect your kidneys, and help you live as normally and actively as possible, including continuing your work. With close follow-up and a tailored treatment plan, many people with lupus nephritis live full and stable lives without progressing to dialysis.

I hope this helps.

Please follow up if you have any further concerns.

Thank you.