Lupus Nephritis and Chronic Kidney Disease

Chronic kidney disease (CKD) is a long-term condition in which the kidneys do not work as well as healthy kidneys. CKD tends to worsen over time. But early detection and management can help protect the kidneys and prevent complications.^1,2

Different conditions can damage the kidneys and lead to CKD. One such condition is a kidney disease called lupus nephritis.^1,2

Why are the kidneys important?

The kidneys perform the following vital jobs:^1,2

• Filter wastes out of the blood
• Balance the amount of water in the body
• Control blood levels of salts and minerals, like calcium, phosphorus, sodium, and potassium
• Make hormones
• Control blood pressure
• Make red blood cells
• Keep bones strong

CKD interferes with the kidneys’ ability to perform these jobs. Loss of kidney function leads to fluid and waste build-up in the body.^1,2

What causes CKD?

Diabetes and high blood pressure cause CKD in more than 60 percent of cases. Kidney disease from high blood pressure and diabetes gets worse slowly over time.¹

Another condition that can damage the kidneys is lupus nephritis. Lupus nephritis leads to inflammation and scarring of the kidneys. Kidney disease from lupus nephritis is more episodic than CKD caused by high blood pressure and diabetes.¹

Other causes of CKD include:¹

• Glomerulonephritis (damage to the tiny filters inside your kidneys)
• Inherited kidney diseases, including polycystic kidney disease
• Bladder and kidney issues present at birth
• Blockage by kidney stones or tumors

What is lupus?

Systemic lupus erythematosus (SLE) is also called lupus. Lupus is an autoimmune disease. Autoimmune means the body’s immune system mistakenly attacks the body’s normal cells and organs. Lupus is a chronic condition but can also cause periodic flares.³

What is lupus nephritis?

Kidney problems are a common and serious complication of lupus. In people with lupus, the immune system produces proteins that cause inflammation in the kidneys. This inflammation can lead to scarring and permanent kidney damage. Kidney disease in people with lupus is called lupus nephritis.⁴

How common is lupus nephritis?

About 60 percent of people with lupus develop nephritis. Compared to non-Hispanic white people, lupus nephritis is 4 times more common in people of African and Asian descent and 2 times more common in Hispanic and Native people.^5,6

What are the risks of lupus nephritis?

Not everyone with lupus nephritis progresses to CKD. But if lupus nephritis is not treated, it can lead to permanent kidney damage. Up to 3 in 10 people with lupus nephritis develop kidney failure. Regular testing for people with lupus is critical to identify kidney damage early.^3,4,6

What are the signs of lupus nephritis?

Signs of lupus nephritis include:^3,6

• Swelling in the feet, ankles, legs, hands, and face
• Foamy or frothy urine
• Blood in the urine
• Protein in the urine (on a urine test)
• High blood pressure

How is lupus nephritis treated?

The goal of lupus nephritis treatment is to stop the body’s immune system from attacking the kidneys. Treatment targets inflammation to reduce the risk of irreversible kidney damage.^3,6,7

Doctors treat lupus nephritis with the following drugs:^3,6,7

• Steroids (prednisone) – control inflammation
• Immunosuppressants (cyclophosphamide, mycophenolate mofetil) – stop the immune system from attacking the kidneys
• Antimalarial drugs (hydroxychloroquine) – a common treatment for lupus
• Blood pressure drugs – lower blood pressure and prevent kidney damage
• Lupkynis^TM (voclosporin) – an oral drug that stops the immune system from causing kidney damage due lupus nephritis
• Benlysta^® (belimumab) – a biologic drug used with other lupus drugs to target the underlying cause of lupus

If you have lupus, talk to your doctor about testing for kidney disease. Early diagnosis and treatment can reduce the amount of kidney damage.^3,4,6