Diagnosis

Tests to diagnose lupus nephritis include:

  • Blood and urine tests. In addition to standard blood and urine tests, you may be asked to collect your urine for an entire day. These tests measure how well your kidneys are working.
  • Kidney biopsy. A biopsy — where your doctor removes a small section of kidney tissue for lab analysis — is the most definitive test for diagnosing lupus nephritis. It can also help determine how severe your disease is.

Treatment

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

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

Conservative treatments

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

  • Diet changes. Limiting the amount of protein and salt in your diet can improve kidney function.
  • Blood pressure medications. Drugs called angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) can help control blood pressure. These drugs also prevent protein from leaking from the kidneys into the urine. Drugs called diuretics can help you get rid of excess fluid.

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

Immune suppressants

For severe lupus nephritis, you might take drugs that slow or stop the immune system from attacking healthy cells, such as:

  • Steroids, such as prednisone
  • Cyclosporine
  • Tacrolimus
  • Cyclophosphamide
  • Azathioprine (Imuran)
  • Mycophenolate (CellCept)
  • Rituximab (Rituxan)

When immunosuppressive therapies don't lead to remission, clinical trials may be available for new therapies.

Treatment options for kidney failure

For people who progress to kidney failure, treatment options include:

  • Dialysis. Dialysis helps remove fluid and waste from the body, maintain the right balance of minerals in the blood, and manage blood pressure by filtering your blood through a machine.
  • Kidney transplant. You may need a new kidney from a donor if your kidneys can no longer function.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Lupus nephritis care at Mayo Clinic

Aug. 15, 2019
References
  1. Lupus and kidney disease (Lupus nephritis). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/lupus-nephritis. Accessed June 14, 2019.
  2. Lupus and kidney disease (Lupus nephritis). National Kidney Foundation. https://www.kidney.org/atoz/content/lupus. Accessed June 14, 2019.
  3. Jameson JL, et al., eds. Glomular diseases. In: Harrison's Principles of Internal Medicine. 20th ed. New York, N.Y.: The McGraw-Hill Companies; 2018. https://accessmedicine.mhmedical.com. Accessed June 17, 2019.
  4. AskMayoExpert. Lupus nephritis. Rochester, Minn.: Mayo Foundation for Medical Education and Research;2018.
  5. Bomback AS, et al. Diagnosis and classification of renal disease in systemic lupus erythematosus. https://www.uptodate.com/contents/search. Accessed June 14, 2019.
  6. Fervenza FC (expert opinion). Mayo Clinic, Rochester, Minn. July 1, 2019.
  7. Warner KW. Allscripts EPSi. Mayo Clinic, Rochester, Minn. June 26, 2019.
  8. Warner KW. Allscripts EPSi. Mayo Clinic, Rochester, Minn. June 27, 2019.
  9. Kidney transplant. Organ Procurement and Transplantation Network. https://optn.transplant.hrsa.gov/data/view-data-reports-build-advanced/. Accessed May 21, 2019.