I am 34, female. Can Mycophenolate and steroids harm my kidneys?

Question

Hi doctor,

I am a 34-year-old woman diagnosed with Class IV lupus nephritis. My latest laboratory results show proteinuria of 3 g/day and a creatinine level of 1.6 mg/dL. I have been started on mycophenolate and steroids, but I am worried about the risk of long-term kidney failure.

What are the chances of maintaining kidney function with current therapies, and when do doctors consider adding newer biologics such as Belimumab?
How should I monitor for treatment-related complications, including infections or bone health issues?

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

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

Because lupus nephritis is an autoimmune disease mediated by the immune system, there is no definitive cure. The condition can cause symptoms such as swelling of the face, hands, and feet; blood in the urine; and high blood pressure. It also leads to elevated creatinine levels in the blood and increased protein excretion in the urine.

Women are more likely to be affected by lupus. If the disease continues to progress and kidney failure develops, dialysis may be required. However, with appropriate medications, dietary changes, and lifestyle modifications, disease progression can often be controlled to a significant extent.

Medications such as corticosteroids and immunosuppressants help reduce inflammation and are essential parts of treatment. Medicines to control blood pressure are also required.

Dietary management is important, and strict limitation of salt and protein intake is advised. Autoimmune diseases also require lifestyle modifications, including stress management, a nutrient-rich diet, and maintaining a proper sleep schedule.

I request that you share your laboratory reports so that I can provide more accurate guidance regarding your disease progression.

I hope this has helped you.

Please feel free to reach out to me again for further queries.

Thank you.