Does kidney disease from lupus develop without symptoms?

Question

Hi doctor,

I am 49 and was diagnosed with lupus nephritis, and I am still shocked at how fast everything happened. I did not even feel sick until my kidneys were already affected pretty badly. That is the part I do not understand at all. Does kidney disease from lupus really remain quiet for that long before symptoms appear?

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Usually, lupus nephritis is asymptomatic. Sometimes, it may be seen as lower limb edema and/or hypertension. Lupus nephritis, however, is generally diagnosed through regular screening.

This makes it clear that routine follow-up and testing for lupus are necessary because there are certain features of the condition that can only be diagnosed by laboratory testing, even when the patient feels fine.

In order to diagnose kidney problems, you need to conduct urinalysis and a 24-hour urine protein every three to four months, regardless of whether the patient is currently experiencing an episode of the condition or not,in order to check whether future flares might occur.

When it comes to diagnosing lupus nephritis, the renal biopsy must be done in order to know the exact type of nephritis and, hence, come up with a treatment plan depending on the type of nephritis.

Investigations to be done include:

Urinalysis.
24-hour urine protein.
Anti-dsDNA (double-stranded DNA).
C3 and C4 (complement components 3 and 4) antigens.

We would appreciate it if you could get back to us after receiving the results of your renal biopsy.

Feel free to contact me for any clarification.

Thank you.