Lupus and kidney damage

Kidney involvement is one of the possible complications of systemic lupus erythematosus. Called lupus nephritis, it requires close monitoring because it can sometimes develop without obvious signs.

This sheet complements the general information presented in the topic "Manifestations of lupus", explaining more precisely how kidney involvement is detected, assessed and monitored.

How is kidney function monitored?

Monitoring is based primarily on blood and urine tests, carried out regularly according to the patient's condition.

Urine tests can detect the abnormal presence of protein (proteinuria) or blood (hematuria or microhematuria) in the urine. Their presence strongly suggests lupus nephritis.

Blood and urine tests can be used to assess kidney function, particularly through the measurement of proteinuria, creatinine levels, and estimation of the glomerular filtration rate.

Blood pressure control is also among the elements that are regularly monitored.

These results should not be interpreted in isolation: they are analyzed by the doctor with all clinical and biological data.

Why might a renal biopsy be recommended?

When kidney damage is suspected or confirmed, a renal biopsy may be recommended depending on the severity of the situation. This procedure involves taking a small sample of kidney tissue using a guided puncture for microscopic analysis.

It allows for a more precise determination of the type and severity of kidney damage and thus contributes to the choice of the most appropriate treatment.

Support tailored to each situation

The treatment of lupus nephritis therefore depends on the nature and severity of the kidney damage.

Depending on the situation, several treatments can be used to control lupus activity and protect the kidneys. Management also includes controlling blood pressure and other factors that can impair kidney function.

The choice of medications and their adjustment are the responsibility of the specialized medical team.

Specialized and regular monitoring

In cases of kidney involvement, management generally involves a lupus specialist and a nephrologist.

Monitoring allows us to assess, in particular:

• kidney function;

• the presence of protein or blood in the urine;

• blood pressure;

• lupus activity;

• the effectiveness and tolerability of the treatments.

The frequency of consultations and examinations depends on each patient's situation and the progression of the disease.

Key points to remember

Kidney involvement in lupus requires regular monitoring, even when it causes few or no symptoms.

Blood and urine tests allow for its detection and monitoring. When necessary, a renal biopsy helps the medical team to precisely characterize the damage and choose the appropriate treatment strategy.

Early intervention and specialized follow-up are essential to best preserve kidney function.

This information sheet is for general information purposes only. It does not replace a consultation or personalized medical advice for diagnosis and follow-up.

Sources: PNDS Systemic Lupus of Adults and Children (2024) — Reference Centres / RAISE / FAI²R Network; Health Insurance.

Content reviewed and validated by Professor Saïd Norou DIOP, specialist in Internal Medicine, medical advisor for TAHIRAH CARE.