What does protein in urine indicate for a person with lupus?

Question

Hello doctor,

My rheumatologist recently told me I have lupus nephritis after routine laboratory tests (labs) showed protein in my urine. I am a 26-year-old female, and honestly, the kidney part scares me more than the lupus diagnosis itself. My urine protein-to-creatinine ratio was elevated, and my doctor is arranging further testing.

What does protein in urine mean for someone with lupus at 26? Does it automatically mean permanent kidney damage is already happening, or can it improve if treatment starts early enough?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Elevated protein in urine means activity from lupus and does not mean that your kidneys are approaching failure or anything. Lupus affects the kidney in different grades, from grade 1 to grade 6, which is the end-stage disease. Grade 3 and grade 4 are usually the active disease ones, and these resolve with proper induction therapy.

The key here is to undergo a renal biopsy first to determine your lupus nephritis class, and based on it, the treatment will be determined. Otherwise, many cases of lupus nephritis recover with proper management and enjoy a happy, long life. As long as you follow up regularly and receive your medications properly, everything will be alright.

The probable cause is lupus nephritis. I would recommend that you get a renal biopsy done. The treatment plan, would be based on the renal biopsy results. Medications recommended include:

Pulse Methylprednisolone intravenous 1 gram per day for 3 days, followed by oral Prednisolone 1 milligram per kilogram per day for 4 weeks before gradual withdrawal.
Mofetil 2 grams, Cyclosporine 5 milligrams per kilogram per day, Hydroxychloroquine 5 milligrams per kilogram per day.
Captopril 50 milligrams per day, and Calcium and Vitamin D supplements.

Regarding follow-up, please follow up after the biopsy results. Preventive measures include avoiding nephrotoxic agents, avoiding analgesics, and maintaining good hydration.

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

Thank you.