Why does lupus nephritis cause swelling in the belly at 48?

Question

Hello doctor,

I am a 48-year-old with lupus nephritis and am currently taking Mycophenolate mofetil and Prednisone.

For the past few weeks, I have been experiencing swelling in my legs, and now my abdomen also feels swollen and tight. My doctor mentioned that this is due to lupus, but did not explain it in detail.

Why does lupus nephritis cause abdominal swelling?
Could this be caused by something else?
Does this mean my kidney function may be worsening even though I am already taking medication?

The swelling has become significant, and my clothes no longer fit properly. Should I seek urgent medical attention, or is it safe to wait until my next appointment, which is scheduled in about a month?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

I am sorry you are dealing with this. The combination of swelling in your legs and a new, swollen, tight abdomen should not be ignored, especially with a history of lupus nephritis (a type of kidney disease).

Lupus nephritis may be responsible for swelling since inflammatory conditions impair the ability of the kidney to maintain proteins within the bloodstream and eliminate excess fluids from the body.

Protein loss in the urine causes a reduction in the concentration of albumin in the blood. Albumin assists in maintaining fluids within the bloodstream; hence, low levels lead to accumulation of fluids in the tissues, causing leg swelling (edema), and sometimes fluid to collect in the abdomen (ascites).

In addition, if the kidneys are not filtering properly, the body retains salt and water, which further contributes to swelling.

Even if you are taking Mycophenolate mofetil and Prednisone, lupus nephritis can sometimes remain active, flare up again, or progress despite treatment, so new or worsening swelling deserves prompt medical reassessment.

However, there are other reasons for this condition as well. Abdominal swelling may also occur due to liver diseases, heart failure, infections, blood clots, side effects of medications, or even other abdominal disorders. For this reason, it is necessary not to think that lupus is the sole reason behind this symptom.

You will need to contact your nephrologist or rheumatologist right away and request an appointment well before one month, or go to the urgent care facility or hospital if you cannot make an appointment before then.

You will likely need an examination, along with tests such as

Kidney function (creatinine).
Urine protein measurement.
Urinalysis (a urine test).
Blood albumin.
Electrolytes.
Possibly an ultrasound of the abdomen to determine why the fluid is accumulating and whether your treatment needs adjustment.

Do not increase or stop your Prednisone or Mycophenolate on your own.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.