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Lupus nephritis treatment will vary, depending on the specific needs and the condition of the patient. Medications are usually used, and some doctors may also recommend plasmapheresis, which is a blood filtering procedure. Lupus nephritis refers to a kidney disease that is caused by lupus, an autoimmune disorder. It can result in impaired kidney function or kidney failure, as well as bloody urine and kidney inflammation.
Not every patient will be able to undergo certain lupus nephritis treatment methods. For example, women who wish to become pregnant in the future will be unable to use certain drugs that can damage the ovaries. Patients with other medical conditions that affect the kidneys will also need to undergo treatment to correct those problems. Those with high blood pressure will likely take additional medicines to control this condition. Some patients will also be instructed to consume specific amounts of protein, salt, and potassium, as well as overall calories, because changes in diet can help to slow the progression of the disease.
In order to determine the correct type of lupus nephritis treatment for the patient, the doctor will perform a number of tests. He will check for protein or blood in the patient's urine, because this indicates damage to the kidneys. The patient will also have a blood test to check for urea and creatinine, because high levels of these substances indicates that his kidney function is becoming impaired. A kidney biopsy is also typically required, because examining a small sample of kidney tissue will inform the doctor if the disease is advanced.
While there is no cure for lupus nephritis, some drugs may help to slow the progression of the disease and retain kidney function. Other medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may adversely affect the function of the kidneys, and these should be avoided. Patients who have edema, or swelling caused by water retention, can benefit from diuretic drugs, which remove excess fluid.
Doctors often prescribe corticosteroids for lupus nephritis treatment, particularly if the disease is not yet advanced. These drugs, which include prednisone, reduce the body's inflammatory response to the autoimmune disorder. They can also cause serious side effects, particularly when used for a long time or in high doses. Patients should be aware that corticosteroids may increase the risk of osteoporosis, cataracts, and infections. Those who use corticosteroids for lupus nephritis treatment will likely be prescribed calcium supplements to help reduce the risk of osteoporosis.
Immunosuppressant drugs may also be used to slow the progression of lupus nephritis. These drugs include azathioprine, cyclophosphamide, and mycophenolate mofetil. Doctors may recommend these drugs if the patient has a poor response to corticosteroids, if he experiences severe side effects from steroids, or if he has severe renal lesions.
Plasmapheresis is another option for lupus nephritis treatment. For this non-invasive procedure, the patient is connected to a machine that filters the blood. Some of the patient's blood is drawn toward the machine through a catheter in one arm, and it returns intravenously to the other arm after it is filtered. During the filtering process, the plasma, or liquid, part of the blood is removed. Sterile saline solution is used to replace the plasma, along with immunoglobulin, which is a solution of healthy antibodies that can help treat autoimmune disorders.