Skip to main content
        
        U.S. flag
                An official website of the United States government
                    Here’s how you know
                Here’s how you know**Official websites use .gov**
                        
                        A **.gov** website belongs to an official government organization in the United States.
            **Secure .gov websites use HTTPS**
                        
                        A **lock** (
                        Locked padlock icon
                        ) or **https://** means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.Search
    Menu

        Search for Information from NIDDK
            
            Entire Site
                Research & Funding
                Health Information
                News
                About NIDDKSearch

Home
            Research & Funding
                                Expand Research & Funding
                                Current Funding Opportunities
                                                    Research Programs & Contacts
                                                    Human Subjects Research
                                                    Funding Process
                                            Research Training & Career Development
                                                    Funded Grants & Grant History
                                                    Research Resources
                                            Research at NIDDK
                                                    Technology Advancement & Transfer
                                                    Meetings & Workshops
                        Health Information
                                Expand Health Information
                                Health Topics
                                                                                                    Diabetes
                                                    Digestive Diseases
                                                    Kidney Disease
                                                    Weight Management
                                                    Liver Disease
                                                    Urologic Diseases
                                                    Endocrine Diseases
                                                    Diet & Nutrition
                                                    Blood Diseases
                                                    Diagnostic Tests
                                            La información de la salud en español
                                                    Health Statistics
                                                    Healthy Moments Radio Broadcast
                                                    Clinical Trials
                                            For Health Professionals
                                                    Diabetes Discoveries & Practice Blog
                                                    Community Health & Outreach
                        News
                                Expand News
                                News Archive
                                                    For Reporters
                                            Meetings & Workshops
                                                    Media Library
                                            Follow Us
                        About NIDDK
                                Expand About NIDDK
                                Meet the Director
                                                    Offices & Divisions
                                                    Staff Directory
                                                    Budget & Legislative Information
                                            Advisory & Coordinating Committees
                                                    Strategic Plans & Reports
                                                    Research Areas
                                                    FAQs
                                            Jobs at NIDDK
                                                    Visit Us
                                                    Contact Us Home
                    Health Information
                    Kidney Disease
                    Lupus Nephritis

    Related Topics
        Kidney Disease
        Acquired Cystic Kidney Disease
                Kidney Disease in Children
Show child pages
        Nephrotic Syndrome in Children
                Hemolytic Uremic Syndrome in Children
                Helping Your Child Adapt to Life with Chronic Kidney Disease
                Ectopic Kidney
                Medullary Sponge Kidney
                Multicystic Dysplastic Kidney
                Amyloidosis & Kidney Disease
                Anemia
                Chronic Kidney Disease (CKD)
Show child pages
        What Is Chronic Kidney Disease?
                Causes of CKD
                Tests & Diagnosis
                Managing CKD
                Eating Right
                Preventing CKD
                What If My Kidneys Fail?
                Clinical Trials
                Diabetes Insipidus
                Glomerular Disease
Show child pages
        Anti-GBM (Goodpasture’s) Disease
                Heart Disease
                High Blood Pressure & Kidney Disease
                IgA Nephropathy
                IgA Vasculitis
                Keeping Kidneys Safe: Smart Choices about Medicines
                Kidney Failure
Show child pages
        What is Kidney Failure?
                Choosing a Treatment
                Hemodialysis
                Peritoneal Dialysis
                Kidney Transplant
                Conservative Management
                Eating Right
                Financial Help for Treatment of Kidney Failure
                Lupus Nephritis
                Mineral & Bone Disorder
                Nephrotic Syndrome in Adults
                Polycystic Kidney Disease (PKD)
Show child pages
        What is PKD?
                Autosomal Dominant PKD
                Autosomal Recessive PKD
                Eating, Diet, & Nutrition for PKD
                Renal Artery Stenosis
                Renal Tubular Acidosis
                Simple Kidney Cysts
                Solitary or Single-functioning Kidney
                Your Kidneys & How They WorkLupus & Kidney Disease (Lupus Nephritis)
**On this page:**
What is lupus nephritis?
    What do your kidneys do?
    Who gets lupus?
    How common is lupus nephritis?
    Who is more likely to develop lupus nephritis?
    What are the symptoms of lupus nephritis?
    What tests do health care professionals use to diagnose lupus nephritis?
    How do doctors treat lupus nephritis?
    What should I eat if I have lupus nephritis?
    What are the complications of lupus nephritis?
    Clinical TrialsWhat is lupus nephritis?
Lupus nephritis is a type of kidney disease caused by systemic lupus erythematosus (SLE or lupus). Lupus is an autoimmune disease—a disorder in which the body’s immune system attacks the body’s own cells and organs. Kidney disease caused by lupus may get worse over time and lead to kidney failure. If your kidneys fail, you will need dialysis or a kidney transplant to maintain your health.
Urinary tract, which includes the kidneys, ureters, bladder, and urethra.Your kidneys are located in the middle of your back, just below your ribcage.What do your kidneys do?
The kidneys’ main job is to filter extra water and wastes out of your blood to make urine. To keep your body working properly, the kidneys balance the salts and minerals—such as calcium, phosphorus, sodium, and potassium—that circulate in the blood. Your kidneys also make hormones that help control blood pressure, make red blood cells, and keep your bones strong.Who gets lupus?
Lupus is much more common in women than in men and most often strikes during the child-bearing years. Nine out of 10 people who have lupus are women. Lupus is also more common in people of African or Asian background. African Americans and Asian Americans are about 2 to 3 times more likely to develop lupus than Caucasians.1 In the United States, 1 out of every 250 African American women will develop lupus.2
How common is lupus nephritis?
Kidney damage is one of the more common health problems caused by lupus. In adults who have lupus, as many as 5 out of 10 will have kidney disease. In children who have lupus, 8 of 10 will have kidney disease.3
Who is more likely to develop lupus nephritis?
African Americans, Hispanics/Latinos, and Asian Americans are more likely to develop lupus nephritis than Caucasians.4 Lupus nephritis is more common in men than in women.5
What are the symptoms of lupus nephritis?
The symptoms of lupus nephritis may include foamy urine and edema—swelling that occurs when your body has too much fluid, usually in the legs, feet, or ankles, and less often in the hands or face. You may also develop high blood pressure.
Kidney problems often start at the same time or shortly after lupus symptoms appear and can include
joint pain or swelling
    muscle pain
    fever with no known cause
    a red rash, often on the face, across the nose and cheeks, sometimes called a butterfly rash because of its shapeA health care professional checking a patient’s blood pressure.Check your blood pressure. High blood pressure can be a sign of lupus nephritis.What tests do health care professionals use to diagnose lupus nephritis?
Lupus nephritis is diagnosed through urine and blood tests and a kidney biopsy.
Urine Test
Your health care professional uses a urine sample to look for blood and protein in your urine. You collect the urine sample in a container in a health care professional’s office or lab. For the test, a nurse or technician places a strip of chemically treated paper, called a dipstick, into the urine. Patches on the dipstick change color when blood or protein is present. A high level of protein or a high number of red blood cells in the urine means kidney damage. The urine will also be examined under a microscope to look for kidney cells.
Blood Test
Your health care professional uses a blood test to check your kidney function. The blood test measures creatinine, a waste product from the normal breakdown of muscles in your body. Your kidneys remove creatinine from your blood. Health care professionals use the amount of creatinine in your blood to estimate your glomerular filtration rate (GFR). As kidney disease gets worse, the level of creatinine goes up.
Read more about blood and urine tests for kidney disease.
Kidney Biopsy
A kidney biopsy is a procedure that involves taking a small piece of kidney tissue for examination under a microscope. A doctor performs the biopsy in a hospital using imaging techniques such as ultrasound or acomputed tomography (CT) scan to guide the biopsy needle into the kidney. Health care professionals numb the area to limit pain and use light sedation to help you relax during the procedure.
The kidney tissue is examined in a lab by a pathologist—a doctor who specializes in diagnosing diseases.
A kidney biopsy can
confirm a diagnosis of lupus nephritis
    find out how far the disease has progressed
    guide treatmentThe American College of Rheumatology recommends biopsies for people with signs of active lupus nephritis who have not yet been treated.3 Early diagnosis and prompt treatment may help protect your kidneys.
How do doctors treat lupus nephritis?
Health care professionals treat lupus nephritis with medicines that suppress your immune system so it stops attacking and damaging your kidneys. Goals of treatment are to
reduce inflammation in your kidneys
    decrease immune system activity
    block your body’s immune cells from attacking the kidneys directly or making antibodies that attack the kidneysMedicines
Your health care professional may prescribe a corticosteroid, usually prednisone, and a medicine to suppress your immune system, such as cyclophosphamide or mycophenolate mofetil, and hydroxychloroquine, a medicine for people who have SLE.
Lupus nephritis can cause high blood pressure in some people. You may need more than one kind of medicine to control your blood pressure. Blood pressure medicines include:
ACE inhibitors and ARBs, with drug names that end in –pril or –sartan.
    diuretics
    beta blockers
    calcium channel blockersACE inhibitors and ARBs may help protect your kidneys, and diuretics help your kidneys remove fluid from your body.
Read more about medicines and treatment for high blood pressure.
A health care professional talking to a patient about medicine.Take medicines as prescribed by your health care professional.What should I eat if I have lupus nephritis?
If you have kidney disease, you may need to change what you eat. Dietitians are nutrition experts who can advise you about healthy eating and meal planning. Find a registered dietitian who can help you. Eating the right foods can help you manage your kidney disease. If you have high blood pressure, eating foods with less sodium (a part of salt) may help you lower your blood pressure.
Read more about eating right for chronic kidney disease.
A dietitian talking to a patient about healthy food.Meet with a dietitian to learn how to plan meals to help manage your blood pressure and kidney health.What are the complications of lupus nephritis?
Treatment works well to control lupus nephritis, so you may not have complications.
Between 10 to 30 percent of people who have lupus nephritis develop kidney failure.6Learn more about what happens if your kidneys fail.
The most severe form of lupus nephritis, called diffuse proliferative nephritis, can cause scars to form in the kidneys. Scars are permanent, and kidney function often declines as more scars form. Early diagnosis and treatment may help prevent long-lasting damage.
People who have lupus nephritis are at a high risk for cancer, primarily B-cell lymphoma—a type of cancer that begins in the cells of the immune system. They are also at a high risk for heart and blood vessel problems.
References
[1] Pons-Estel GJ, Alarcón GS, Scofield L, Reinlib L, Cooper GS. Understanding the epidemiology and progression of systemic lupus erythematosus. *Seminars in Arthritis and Rheumatism.* 2010;39(4):257–268.
[2] Madhok R. Systemic lupus erythematosus: lupus nephritis. *BMJ Clinical Evidence.* 2015 Dec 18:pii:1123.
[3] Liu CC, Kao AH, Manzi S, Ahearn JM. Biomarkers in systemic lupus erythematosus: challenges and prospects for the future. *Therapeutic Advances in Musculoskeletal Disease.* 2013;5(4):210–233.
[4] Diagnosis and classification of renal disease in systemic lupus erythematosus. UpToDate website. Updated March 24, 2016. Accessed October 19, 2016.
[5] Hahn BH, McMahon M, Wilkinson A, et al. American College of Rheumatology guidelines for screening, treatment and management of lupus nephritis. *Arthritis Care & Research.* 2012;64(6):797–808.
[6] Ortega LM, Schultz DR, Lenz O, Pardo V, Contreras GN. Review: lupus nephritis: pathologic features, epidemiology and a guide to therapeutic decisions. *Lupus.* 2010;19(5):557–574.Clinical Trials
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.
What are clinical trials, and are they right for you?
Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.
What clinical trials are open?
Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov.        Last Reviewed January 2017
Sharethis page

Print
    Facebook
    X
    Email
    
    More Options
    
    WhatsApp
    LinkedIn
    Reddit
    Pinterest
    
    Copy Link
                
                This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.
    The NIDDK would like to thank:The National Institute of Arthritis and Musculoskeletal and Skin Diseases Contact Us
**Hours:** 8:30 a.m. to 5 p.m. ET, Monday - Friday**Email:** healthinfo@niddk.nih.gov**Phone:** +1-800-860-8747**TTY:** +711
Chat
Live Chat Available8:30 a.m - 5 p.m. ETMonday - Friday
Follow Us
LinkedIn
X
Facebook
YouTube
InstagramNIH... Turning Discovery Into Health ®
Privacy Policy
    Freedom of Information Act
    Accessibility
    Disclaimers
    Copyright
    Vulnerability Disclosure Policy
Site Map
    For Staff Only
    Get Email Updates
U.S. Department of Health and Human Services
    National Institutes of Health