About Lupus Nephritis

Lupus nephritis is not as uncommon as you may think, and can lead to serious complications if left untreated.

The Role of SLE

Systemic lupus erythematosus (SLE) or lupus is a chronic, complex, and often disabling autoimmune disorder in which the body’s immune system (which fights off bacteria and viruses) attacks the body’s own cells, tissues, and organs. Lupus can affect many parts of the body including the joints, skin, brain, heart, lungs, and kidneys. When it affects the kidneys, it’s called lupus nephritis.

What is lupus nephritis (LN)?

Lupus nephritis is a rare disease—but it's one of the most common and serious complications of lupus, affecting about 50% of people living with it. Lupus nephritis can lead to irreversible kidney damage or even kidney failure—which may require dialysis or a kidney transplant.

It's critically important to catch lupus nephritis early. Early diagnosis and treatment may help prevent irreversible kidney damage and other serious complications.

Know your risks–complications of lupus nephritis include:

Increased blood pressure

Cardiovascular complications

Includes risk of heart attacks and strokes

Chronic kidney disease

Happens when the kidneys are slowly damaged over time and can't filter blood the way they should

Scarring of the kidneys

Permanent damage that results from the disease progressing

Kidney failure, also known as end‑stage kidney disease (ESKD) or end‑stage renal disease (ESRD)

Up to 30% of people who have lupus nephritis will experience kidney failure

Kidney function is measured by glomerular filtration rate (GFR). As kidney disease worsens, the number goes down. A GFR of 60 or above is normal; any lower may indicate kidney disease. If your GFR reaches 15 or lower, that may mean kidney failure which can result in the need for dialysis or a transplant

Treatment and/or steroid-related complications

High doses of steroids may increase the risk for adverse events, including irreversible organ damage

Every person and every situation is different. It's important to speak with a doctor about your risk and a treatment plan that may be appropriate for you.

Early diagnosis and treatment can help prevent irreversible kidney damage and other serious complications.

Monique

diagnosed with lupus nephritis in 2010

"There’s still no cure for lupus nephritis, this is really important to know. That’s why active surveillance and early detection is key, along with self-management. Now is the time to check in on your kidney health."

Get help managing lupus nephritis

Who is affected?

Lupus nephritis is one of the most common complications of lupus. In fact, about 1 in 3 people are diagnosed with it at the time of their lupus diagnosis, and about half of people with lupus may go on to develop it later. Even though lupus nephritis typically begins in people around 20-30 years of age, the number of people that get diagnosed each year tends to continue to increase with age. As far as gender, it's more common among women, but tends to affect men more severely.

Lupus nephritis is more common in some racial and ethnic groups than others

4x more likely for people of African and Asian descent^α

2x more likely for Hispanic and Native peoples^α

^αCompared to non-Hispanic white people

Start the discussion early.

Staying on top of your appointments and getting the most out of your time with your doctor is crucial to catching lupus nephritis as early as possible. Use this guide to help ensure you're asking the right questions.

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Signs, symptoms, and classes of lupus nephritis

Symptoms of lupus nephritis can be subtle, inconsistent, or hard to recognize—that's why frequent testing is so important. See the types of tests used to diagnose LN

Swelling
(often in the feet, ankles, or legs)

Weight gain

Foamy or frothy urine
(small bubbles in urine)

Frequent urination
(especially at night)

Lupus nephritis is a serious disease with severe complications. Even if you don't see symptoms, you may have permanent kidney damage. That's why it's important to prioritize regular doctor visits—even when symptoms are subtle or unnoticeable. Routine testing by a doctor is key to helping you stay ahead of potential long-term damage and complications.

Clinical signs that require testing include:

High levels of protein in the urine (known as proteinuria) that show up in a clinical laboratory urine test

Blood in the urine (known as hematuria)

Increased blood pressure

Inflammation or scarring of the kidneys, as confirmed through a kidney biopsy

Unbalanced levels of electrolytes, or minerals in the body, measured through a blood test

Slower rate of blood filtration through the kidneys, known as glomerular filtration rate, measured through a blood test

Increase in creatinine, a waste product that results from the normal breakdown of muscles, measured through a blood test

The key feature of lupus nephritis

Higher than normal levels of protein in the urine (>0.5 grams per day), a condition known as proteinuria.

Classes of lupus nephritis

A rheumatologist or nephrologist will use the results of a kidney biopsy to figure out how lupus nephritis has affected the kidneys. This information can also help doctors decide on an appropriate treatment plan.

Class

Description

Class I

Minimal mesangial lupus nephritis

Minimal kidney involvement

Class II

Mesangial proliferative lupus nephritis

Some evidence of inflammation in limited areas of the kidneys

Class III

Focal lupus nephritis

Involvement of less than half of the network of small blood vessels in the kidneys

Class IV

Diffuse proliferative nephritis

Involvement of more than half of the network of small blood vessels in the kidneys

Class V

Membranous lupus nephritis

Characterized by immune deposits found around the network of small blood vessels

Different from other forms of lupus nephritis

Class VI

Advanced sclerotic lupus nephritis

Damage to more than 90% of the network of small blood vessels in the kidneys

Dina

Diagnosed with lupus nephritis in 1994

"The newly diagnosed need to know it is possible to live a full, happy, and meaningful life with lupus nephritis. It is not a death sentence."

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Want to learn more about your diagnosis?

This discussion guide includes helpful questions to ask at your next doctor's appointment.

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