How to protect my kidneys with lupus nephritis at 33?

Question

Hello doctor,

I am a 33-year-old woman diagnosed with lupus five years ago. Recently, my doctor said that I have lupus nephritis. I feel very fatigued, my legs swell, and I notice foamy urine.

I am scared because I read that lupus can lead to kidney failure. I am also worried about the effects of medicines like steroids and immunosuppressants on fertility, since I still hope to have children.

Are there safer long-term treatments for lupus nephritis in women planning pregnancy?
How can I prevent further kidney damage?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Lupus nephritis is an autoimmune condition that affects the kidneys, causing inflammation and swelling. This inflammation interferes with normal kidney function, leading to improper waste removal from the body, high blood pressure, and, in severe cases, kidney failure.

As this is an autoimmune condition, there is no definitive cure because it is mediated by the immune system. Common symptoms include swelling of the face, hands, and feet; blood in the urine; and high blood pressure.

It also results in raised creatinine levels in the blood and increased protein excretion in the urine. Women are more commonly affected by lupus.

If the disease continues to progress and kidney failure develops, dialysis may be required. However, with appropriate dietary and lifestyle modifications, disease progression can be controlled to a significant extent.

Medications such as corticosteroids and immunosuppressants help reduce inflammation and will need to be initiated. You will also require medications to control blood pressure.

It is essential to strictly limit salt and protein intake in your diet, which I hope you are already aware of.

Pregnancy in lupus nephritis is considered high risk, with increased chances of fetal loss, preterm birth, and maternal hypertension, including eclampsia. An integrated team of doctors is required to manage such pregnancies.

Nowadays, biological medications are also being used for long-term symptom relief. Autoimmune diseases largely require lifestyle changes, including effective stress management, a nutritious diet, and maintaining a proper sleep schedule.

Kindly share your laboratory reports so that I can provide better clarity regarding your disease progression.

I hope this helps you.

For more queries, feel free to reach out to me anytime.

Thank you.