Can lupus nephritis lead to kidney failure at 44?

Question

Hello doctor,

My wife has lupus nephritis, and we just got her latest blood test results back. Her creatinine is 2.4 mg/dL, and her estimated glomerular filtration rate (eGFR) is 31 mL/min/1.73 m². Her rheumatologist said this means her kidneys are not functioning well.

Frankly speaking, we are really scared. At the age of 44, she has two little children. Is it possible that at the age of 44, lupus nephritis can result in total failure of the kidneys, or can something be done to slow down the disease or to make the condition of her kidneys better?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and understood your concern.

Your wife's kidney function may be affected by active lupus nephritis. However, this does not necessarily mean she has reached end-stage kidney disease or that there is no chance of recovery. The first urgent step is a renal biopsy to determine the class of lupus nephritis.

If the biopsy shows class III or class IV lupus nephritis, urgent induction therapy with intravenous (IV) pulse Methylprednisolone, followed by oral Prednisolone and Cyclophosphamide 1 gram once a month for six months, can often control the disease activity.

Cyclophosphamide is generally avoided in patients who wish to become pregnant in the future because it can affect fertility, although it is one of the most effective immunosuppressive medications in severe cases. If pregnancy is a consideration, medications such as Rituximab or Mycophenolate Mofetil (MMF) 3 grams daily may be used instead.

If the biopsy shows class V or class VI lupus nephritis, it may indicate more advanced kidney damage. These forms may not respond as well to immunosuppressive treatment, and some patients may eventually require dialysis or a kidney transplant.

Hopefully, this will not be the case for your wife, and her condition will prove to be manageable with appropriate treatment. At this stage, the renal biopsy is the most important and urgent step before deciding on the best treatment plan.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.