Lupus nephritis is the disease of the kidneys due to lupus. About 30% of lupus patients will develop kidney disease within the first six months to three years of their diagnosis with SLE. In patients with lupus nephritis, an excessively active immune system attacks the patient’s organs and tissues and causes inflammation and damage. Inflammation of the kidney prevents it from functioning normally and can result in the spill of protein and blood in the patient’s urine. As a result, the urine may appear bloody, frothy, or foamy. Other early signs of lupus nephritis may include an increase in blood pressure and swelling of the feet, ankles, and the face, specifically around the eyes.
Prompt diagnosis of lupus nephritis and proper classification of the disease allows for selection of the best therapeutic options for each case. A kidney biopsy is often needed to help with such assessment. The final decision as to which therapeutic option is the best for each patient is made by the patient and the patient’s treating rheumatologist and nephrologist after careful discussion of available options.
The goal of the therapy is to fully control inflammation (Induction Therapy) or to achieve at least major improvement in parameters of kidney function (e.g., reduce the amounts of protein lost in the urine, promote improvement in blood level of creatinine) with minimization of symptoms. This is required to prevent further kidney damage and kidney failure. Once good control of the disease is achieved, Maintenance Therapy is used to prevent further flares.