My iwfe is diagnaosed with lupus nephritis.We under went a biopsy today to confirm the fact. Anyone undergone the same situation and can provide some guidance.
thanks so much
Lupus nephritis is just one of the complications of Systemic Lupus Erythematosus (SLE). It is related to the autoimmune process of SLE where the immune system produces antibodies (ANA) against the body. Complexes of these antibodies and complement accumulate in the kidneys and result in an inflammatory response. This causes several disorders of the internal structure of the kidney, including excessive protein excretion ( Lupus nephritis - aka: nephrotic syndrome) which can progress rapidly and lead to renal failure. There can also be a progressive accumulation of waste products in the blood stream (azotemia) and abnormalities in the urine (protein and blood in the urine).
Symptoms are: blood in the urine, foamy appearance to the urine, swelling of any area of the body, elevated blood pressure (These are in addition to and/or in conjunction with the symptoms of SLE).
Tests for Lupus Nephritis include: Urinalysis to detect protien, casts and red blood cells in the urine; ANA to determine titer; kidney biopsy to determine appropriate treatment for renal complications; Kidney function assessment
Treatments include: Corticosteroids or other immunosuppressive medications (such as Cyclophosphamide); Dialysis to control any symptoms of renal failure; kidney transplant to treat kidney failure.
There has been some tests on a new drug called mycophenolate mofeti (MMF). There was a 24-week study on 140 patients with SLE and advanced stages of lupus nephritis and it was found that some patients experienced remission and/or reduction of symptoms with less side-effects. I have not been able to discover exactly who conducted this study and have found nothing about a clinical trial being conducted by any LUPUS research organizations. But, perhaps you can ask your doctor about it and see what you can find out!!
I hope that I have been helpful and I hope that your wife is able to control this condition as well as her SLE. I want to thank you for being there for her and for educating yourself about this disease. She will continue to need your support and your understanding and one of the best things that you can do for her is to understand and be informed about what she is going through. Bear in mind that SLE and its symptoms can also cause chemical imbalances that lead to depression (this is common amongst us SLE sufferers). Be very patient with her and know that what she is feeling is very real to her!
Peace and Blessings
full MMF study
Mycophenolate Mofetil Effective for SLE When Other Drugs Fail
NEW YORK (Reuters Health) Jun 24 - Mycophenolate mofetil (MMF) is effective in reducing disease activity in patients with systemic lupus erythematosus (SLE) resistant to other immunosuppressive therapy, British investigators report.
MMF is used to control lupus nephritis and other SLE manifestations, Dr. Cecilia N. Pisoni and colleagues note in their report, published in the June Journal of Rheumatology.
Their study evaluated indications, efficacy and safety of MMF in patients with SLE refractory to other treatments, for which they reviewed records of 86 SLE patients treated at St. Thomas' Hospital in London between 1998 and 2003.
Fifty-nine were treated for lupus nephritis and the remainder for other indications (uncontrolled disease activity, skin or lung involvement, hematological disorders, cerebral lupus, vasculitis and transverse myelitis). All had discontinued therapy with other immunosuppressive agents, including azathioprine and cyclophosphamide, due to lack of efficacy or adverse events.
In those with nephritis, 24-hour protein excretion had declined significantly, from 3.01 to 1.85 g/24 hours), as had steroid doses (17.71 to 9.38 mg/day), and European consensus Lupus Activity Measurement Index (ECLAM; 3.66 to 2.44).
In those treated for other indications, there were significant reductions in steroid dosage (17.95 to 10.86 mg/day), erythrocyte sedimentation rate (38.2 to 29.19 mm/hour), ECLAM score (3.83 to 2.49), antibody titer against double-stranded DNA (47.41 to 30.3 IU/mL), while complement C3 levels increased (0.66 to 0.84 g/L).
Adverse events occurred in 37, primarily gastrointestinal intolerance and infections, though only 14 discontinued the drug. Six patients stopped the MMF when they achieved disease remission and were trying to conceive. Twelve stopped due to lack of efficacy.
In conclusion, the authors write, "MMF appears to be a safe and successful treatment to maintain remission in patients with lupus nephritis and to control overall disease activity."
In an accompanying editorial, Drs. W. Joseph McCune and Mona M. Riskalla, from the University of Michigan in Ann Arbor comment that following monthly bolus cyclophosphamide, MMF as maintenance therapy "will soon become the standard of care" for lupus nephritis in adults and may even be a candidate for first-line therapy.
J Rheumatol 2005;32:1047-1052.