Lupus nephritis care at Mayo Clinic

Your Mayo Clinic care team

Mayo Clinic's multidisciplinary practice allows specialists to leverage the expertise of other Mayo Clinic doctors, including those who focus on kidney disease. Your Mayo Clinic doctors can work closely with your local doctor to ensure that you're getting the right treatment and follow-up care.

Diagnosis

Your doctor may suspect lupus nephritis if you:

  • Have protein in your urine
  • Have foamy looking urine
  • Have elevated creatinine in your blood
  • Have high blood pressure
  • Show signs of swelling in your hands, ankles or feet

Diagnostic tests for lupus nephritis at Mayo Clinic include:

  • Renal function testing. Mayo Clinic nephrologists use a variety of tests, including blood tests and 24-hour urine collection, to accurately measure your kidney function. You may have iothalamate clearance testing, which uses a special contrast dye to show how well your kidneys are filtering. Mayo Clinic is one of the few centers to specialize in iothalamate clearance testing.
  • Kidney biopsy. Biopsy — where your doctor removes a small section of kidney tissue for lab analysis — is the gold-standard test to diagnose lupus nephritis. It can also help determine how severe your disease is. Because of the large number of people treated for kidney diseases, Mayo Clinic has the dedicated Renal Biopsy Laboratory. Having a biopsy performed at Mayo Clinic ensures that it will be done by experienced specialists with an outstanding track record for safety.

Treatment goals

Lupus affects everyone differently, and the disease can cause symptoms affecting nearly any part of the body. Your Mayo Clinic care team will tailor your treatment plan to meet your needs and improve your quality of life.

There's no cure for lupus nephritis. Treatment goals aim to:

  • Induce remission of the active disease
  • Keep the disease from getting worse
  • Reduce symptoms or make symptoms disappear (remission)
  • Avoid the need for dialysis or a kidney transplant
  • Maintain remission

A treatment plan can help you manage symptoms such as high blood pressure, protein in the urine (proteinuria), and swelling (edema) in the hands and feet.

Conservative treatments

In general, doctors may recommend these treatments for people with kidney disease:

  • Dietary protein and salt restriction. A specialized diet can improve kidney function.
  • Blood pressure medications. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) can help control blood pressure and prevent protein from leaking from the kidneys into the urine.

However, conservative treatment alone isn't effective for severe forms of lupus nephritis.

Specialized treatments used when traditional therapies don't work include:

  • Steroids, cyclophosphamide and immunosuppressants. People with severe lupus nephritis need treatment with immunosuppressive therapies to stop the immune system from attacking healthy cells. These drugs include prednisonecyclophosphamide, azathioprine (Imuran), mycophenolate (CellCept) and rituximab (Rituxan) Mayo Clinic experts can help create a treatment plan that maximizes medication benefits and minimizes side effects.
  • Novel therapies. When immunosuppressive therapies don't work to bring on complete remission for people with lupus nephritis, new therapies are needed. Mayo Clinic tests new drugs and therapeutic strategies in clinical trials offered through the Nephrology Collaborative Group.

Treatment options for kidney failure

For people who have lupus nephritis and progress to kidney failure, treatment options include:

  • Dialysis. Dialysis treatments take care of the functions that your kidneys can no longer do. Dialysis helps remove waste from the body, maintain the right balance of minerals in the blood and manage blood pressure. Mayo Clinic offers state-of-the-art dialysis treatment, including the option for in-home dialysis.
  • Kidney transplant. You may need a new kidney from a donor if your kidneys can no longer function. All Mayo Clinic campuses offer kidney transplant. Mayo has performed thousands of kidney transplants with better than average results.

Mayo Clinic's doctors and researchers in the Nephrology Collaborative Group test new therapies and treatments to improve your success in reaching remission.

Advanced diagnosis and treatment

Mayo Clinic experts use the latest diagnostic techniques to help you get an accurate diagnosis as quickly as possible so that you can start treatment.

Because there are many kidney specialists (nephrologists) at Mayo Clinic, they're able to subspecialize within kidney medicine. A number of Mayo Clinic nephrologists specialize in lupus and care for people from all over the world who have lupus nephritis.