Lupus and your kidneys
Upcoming SlideShare
Loading in...5

Lupus and your kidneys






Total Views
Views on SlideShare
Embed Views



21 Embeds 3,289 1846 1087 143 90 28 26 13 10 8 8 6 4 4 4 4 2 2 1 1 1 1



Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
Post Comment
Edit your comment

Lupus and your kidneys Lupus and your kidneys Presentation Transcript

  • Lupus and the kidney Suzanne El-Sayegh, MD Associate Chairman of Medicine Director of Nephrology Staten Island University Hospital
  • Lupus and the kidney
    • SLE is a systemic disease
    • Affects all organs
    • Kidney disease is common
      • Can affect up to 50% of patients
      • Kidneys have high blood flow: high exposure to preformed antibodies
      • Male patients, certain ethnic group are more at risk
  • Lupus and kidney disease
    • Called also lupus nephritis
      • Inflammation of kidneys
      • Can be treated with medications with resolution
      • Or can lead to scarring and fibrosis
  • Manifestation of disease
      • Could be silent
      • Blood in the urine ( that the patient can not see)
      • Protein in the urine ( foamy urine)
      • High blood pressure
      • Edema
      • Renal failure
    • Since disease could be silent:
      • All patients need follow/up with their physician to check BP and to examine the urine for blood and protein
  • Lab tests
    • In order to know if lupus is active in the kidneys we can order some blood tests:
      • Anti DNA will be elevated
      • Complement level ( c3, c4, ) might be low
      • ESR could be high
      • Urinalysis: blood , protein , RBC cats
  • Kidney biopsy
    • Always indicated: why?
      • Define the staging
      • Determine the therapy
      • Assess prognosis
      • Assess chance of recovery
  • Treatment
    • Therapy is divided into standard therapy and specific therapy to target the lupus in the kidneys:
      • Standard therapy:
        • Control blood pressure
        • Control protein in the urine: use angiotensin converting enzyme drugs, or angiotensin receptor blockers
        • Might need to use diuretics ( water pills)
        • Might need to use medication to lower cholesterol specially in patients with heavy proteinuria
    • Targeted therapy:
      • Depends on the result of kidney biopsy
      • Include: induction phase and maintenance phase
      • Medications used: cyclophosphamide, mycophenolate mofetil, azathioprine, rituximab
    • Prognosis depends on the kidney findings
    • If no response and renal function continues to deteriorate patient will require dialysis
    • Kidney transplant is an option
    • Pregnancy is not contraindicated however
      • patients should be stable on low dose of prednisone,
      • lupus should not be active,
      • minimal protein in the urine
      • and good kidney function