| What
is lupus?
Lupus is a short name for a disease called "lupus
erythematosus." Lupus is called an "autoimmune" disease
because the immune system, which usually protects the body from disease,
turns against the body, causing harm to organs and tissues.
There are two types of lupus. “Systemic” lupus
erythematosus (SLE) can harm your skin, joints, kidneys and brain and may
be fatal if untreated. The other type, called "discoid" lupus
erythematosus, affects only your skin.
What causes lupus?
No one knows what causes the disease. Your family
history is important. People with family members who have SLE are much
more likely to develop the disease. Infections, viruses and certain
medications may also play a role in causing the disease.
People of all ages, races and both sexes can get lupus.
However, it is about ten times more common in women than men. About
500,000 Americans have lupus.
What are the symptoms of lupus?
Different people get different symptoms. These may
include: skin rashes, joint pain and swelling, hair loss, sun sensitivity,
tiredness, weight loss, fever, swelling of lymph glands, chest pain, nerve
involvement and ankle swelling.
How can lupus harm the kidneys?
Lupus causes an inflammation of the filtering units (glomeruli)
of the kidney. Since these filtering units clear your blood of waste,
damage to them can cause your kidneys to work poorly or not at all. About
90 percent of lupus patients will have some kidney damage but only a small
percentage actually develop kidney disease severe enough to require
treatment.
The kidney disease may be "silent" and not
cause any symptoms. However, you may have dark urine, pain in your side,
high blood pressure, weight gain from extra fluid, and swelling around
your eyes, hands and feet.
How do I know if I have lupus?
Your doctor will do a physical examination, look at your
medical history and take x-rays and a blood test for
"antinuclear" antibodies and other markers of SLE.
How is lupus treated?
Lupus is treated with anti-inflammatory drugs that block
your body's immune system. Some of these are prednisone, azathioprine,
cyclophosphamide or cyclosporine and mycophenolate.
Do these treatments have side effects?
Yes. These drugs have some side effects. Some cause
cosmetic changes such as hair thinning and weight gain. All cause an
increased susceptibility to infections and tumors. Fortunately, with
modern treatment regimens, these side effects are usually easily
manageable for most patients.
Do I need to follow a special diet?
Sometimes. All patients should follow a well- balanced
diet. When the disease is active, you may have to follow some
restrictions. You need to talk with your doctor or dietitian about the
best diet for you.
If you have kidney disease, you may need to eat less
protein and sodium (salt). If you have high blood pressure, you should be
sure to take the drugs prescribed by your kidney doctor to control your
pressure. If you are overweight, losing weight may help to control your
blood pressure.
How can I tell if the disease has hurt my
kidneys?
The doctor can tell if lupus has harmed your kidneys by
testing for protein or blood in your urine. Also, the levels of urea and
creatinine in your blood will be high if your kidneys are not getting rid
of these waste products as well as usual. Your doctor may estimate your
level of kidney function from the results of your blood creatinine test
and your age, size and gender. This is called you glomerular fitration
rate, or GFR.
What happens if my kidneys fail?
If your kidneys fail, you can be treated with dialysis
or a kidney transplant. Lupus patients do as well with these treatments as
people who have other types of kidney disease.
Many patients with lupus kidney disease have received a
kidney transplant. The drugs used to prevent your body from rejecting the
new kidney are the same or like those used to treat lupus. It is unusual
for lupus to come back in the new kidney. Most of the time, the lupus
stays inactive. Lupus patients with new kidneys do as well as any other
patients with transplanted kidneys.
What is my long-term outlook?
Most patients do well long-term. You may need to take
medication over many years. Even patients who have less involvement should
have periodic checkups.
What can I do to help myself?
You should learn more about the disease and the factors
that cause it to flare up. One of these factors is sun exposure. You
should avoid outdoor activities between 10 a.m. and 4 p.m. when the sun
exposure is greatest. If you must go out, you should apply strong
sunscreens and wear wide-brimmed hats and long-sleeved shirts. You need to
follow your doctor's orders carefully and take your medications as
directed.
Fatigue (tiredness) also can cause the disease to flare
up. You should plan your physical activities carefully and schedule rest
periods. Planned exercise is also helpful.
Chronic illness requires coping as well as understanding
and support from family members. When the disease is active, lupus
patients may have decreased ability to handle household or job-related
tasks. The ability to cope and to be flexible will go a long way toward
learning to live with lupus.
What If I have more questions?
If you have additional questions, you should speak to
your doctor. You may also be interested in the following publications
available from the National Kidney Foundation:
- Warning Signs of Kidney and Urinary Tract Disease
- Your Kidneys: Master Chemists of the Body
- Are You at Increased Risk for Chronic Kidney Disease
- About Chronic Kidney Disease: A Guide for Patients
and their Families
- What You Need to Know About Urinalysis
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