Is kidney transplantation successful for lupus nephritis at 65?

Question

Hi doctor,

My aunt is 65 years old and has had lupus nephritis for several years. Though she has been receiving treatment, her kidney function has been deteriorating, and her nephrologist has lately stated that she might have to undergo a kidney transplant at some point in time. Her creatinine values have been rising, and she gets tired easily.

We are worried about the fact that lupus is an autoimmune disease, and we are not sure whether she will be able to live normally after a kidney transplantation.

Is there any chance of a successful kidney transplantation in a person with lupus nephritis?

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

Kidney transplantation can be effective in patients with lupus but needs potent immunosuppressive drugs before and after the procedure, such as Tacrolimus, to prevent rejection of the organ from an autoimmune reaction.

Before planning a transplantation, I suggest conducting a renal biopsy to classify the lupus nephritis. If the case is classified as class III or IV and is active, it may be possible to salvage the kidney with induction immunosuppressive therapy.

However, if the biopsy reveals class V or VI, then the kidneys are not very likely to improve under the influence of immunosuppression therapy. The suspected diagnosis is lupus nephritis, and the tests that are required are a renal biopsy to confirm the disease.

In the future, the results of renal biopsy need to be controlled. Preventions involve abstaining from nephrotoxic substances, avoiding analgesics, and maintaining hydration.

Feel free to contact me for any other questions.

Thank you.