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Kidney Failure In People With Lupus Nephritis
Inflammation from lupus can cause a type of kidney disease called lupus nephritis. Learn more about how lupus affects the kidneys and lupus nephritis.
For some people with lupus nephritis, lupus causes so much damage to the kidneys that both kidneys stop working. When this happens, it's called kidney failure.
What is kidney failure?Your kidneys clean your blood by filtering out waste and extra water. Kidney failure happens when both kidneys stop filtering waste and extra water properly.
Doctors use a test called eGFR (estimated glomerular filtration rate) to find out how well your kidneys are working. If your kidneys have a low percentage of function, that means they aren't working very well to filter out waste and extra water. Kidney failure means the kidneys have less than 15 percent of function. Your doctor might also use the terms "renal failure, "end-stage renal disease," or "end-stage kidney disease" when talking about kidney failure.
Symptoms of kidney failure can be different for different people. But some common symptoms include:
If you have any of these symptoms, talk to your doctor.
Why do some people with lupus nephritis have kidney failure?In lupus nephritis, the inflammation caused by lupus damages your kidneys. Over time, this damage can cause the kidneys to fail.
The good news is that treatments for lupus nephritis generally work well and can prevent the disease from causing kidney failure. But some people may have kidney failure even if they're getting treated for kidney problems. About 1 to 3 out of every 10 people with lupus nephritis will have kidney failure.
How is kidney failure treated?Without treatment, kidney failure is fatal. But there are treatments that can help — like dialysis and kidney transplantation.
DialysisDialysis is a treatment that takes over the job of the failing kidneys to filter and clean your blood. There are 2 types of dialysis :
Kidney dialysis is a life-saving treatment, but it may have a big impact on a person's life. Individual treatment sessions can take up a lot of time. And because dialysis requires special equipment, people with kidney failure need to carefully plan their activities around dialysis treatment.
Read more about dialysis — including how it can affect your daily life.
Kidney transplantA kidney transplant is surgery to put in a healthy kidney from a donor. Donor kidneys can come from a living person including but not limited to family members, friends, or deceased people who chose to donate their organs.
Before doing a kidney transplant, doctors will carefully check blood and tissue types for you and the donor to see if the donor kidney is a good match. This can help prevent future health problems. It can take time to find the right match — many people who need a kidney wait for 3 to 5 years before receiving a transplant. People with kidney failure who are waiting for a transplant need to do dialysis until they can have surgery.
Kidney transplant comes with risks, including bleeding, infection, transplant rejection and recurrence of lupus nephritis. Transplant rejection means the body attacks or rejects the new kidney. If you get a kidney transplant, you'll need to take medicines to try to prevent transplant rejection.
Unfortunately, not everyone who needs a kidney transplant can get one. That's because there are not enough donor kidneys for the people who need them. In addition, you might not be approved for a transplant if you're above a certain age or have another serious health problem, like cancer.
Learn more about getting a kidney transplant.
Supportive careSupportive care (also called palliative care) is care that aims to help people manage their kidney failure symptoms and feel better. You can have supportive care alongside dialysis or a kidney transplant.
Some people with kidney failure may choose not to have treatment. In these cases, supportive end-of-life care can keep people comfortable until they pass. People with kidney failure may live from one week to several weeks without treatment. Deciding not to have treatment for kidney failure (or to stop treatment) is a personal decision, but it's important to talk with loved ones and your doctor about your choice.
Read more about supportive care for people with kidney failure.
Learn more about kidney failureCheck out these resources to learn more about the how lupus affects the kidneys, kidney failure, and treatment:
Little-known Cancer Signs Often Overlooked As Nurse Issues 'crucial' Warning
Many people only get a kidney cancer diagnosis when being treated for other ailments (Image: GETTY)
Each year, nearly 14,000 Brits receive a kidney cancer diagnosis. Despite the disease having a good prognosis if detected early, many people dismiss initial symptoms, resulting in late-stage diagnoses.
Hazel Jackson, a healthcare professional nurse at Kidney Cancer UK, highlighted that explaining potential symptoms can be challenging as they vary between individuals and can be subtle, easily mistaken for less serious conditions.
One sign of kidney cancer is pain in the lower back or even on just one side (Image:
GETTY)Key symptoms include persistent lower back pain, blood in urine, which can range from light pink to red or even a "cola-like colour", unexplained weight loss, constant fatigue, and persistent night sweats. These symptoms are not exclusive to kidney cancer and can indicate other types of cancer or serious health conditions.
Nurse Hazel has issued a stern warning about the often undetected threat of kidney cancer, highlighting that it can sneak up unsuspectingly, often only caught during tests for other ailments or emergency visits. She emphasised the extreme importance of recognising key symptoms – pointing out the harsh reality that "In many cases, kidney cancer is only discovered through tests for unrelated conditions or a visit to A&E. It is important to note you may not experience all the key symptoms and may in fact only have 1 or 2."
She advises that while these symptoms can indicate other health issues, it's crucial to connect the dots and seek medical advice swiftly: "While these signs can be signs of other conditions, it's important to link them together and contact your GP promptly if you do experience them. Early detection can make a significant difference in the treatment and outcome of any cancer diagnosis."
Nearly 14,000 people each year are diagnosed with kidney cancer (Image:
GETTY)Further intensifying the urgency, Kidney Cancer UK pointed out certain individuals are more at risk and should be particularly vigilant. The charity mentioned that the older population, especially men – who face double the risk compared to women – should be on high alert.
Lifestyle factors like obesity, smoking, and high consumption of red and processed meats markedly elevate the danger, whereas a diet rich in fruits, veggies, and fibre could potentially shield against the disease. Surprisingly, seemingly unrelated health quirks, like having a personal or family history of Birt-Hogg-Dubé syndrome, tuberous sclerosis, or hereditary clear cell and papillary renal cell carcinoma, might also ramp up your kidney cancer risk.
What Is Calciphylaxis?
The main symptom of calciphylaxis includes skin lesions on the lower limbs or areas with higher fat content, such as the:
The lesions eventually progress to extremely painful ulcers or nodules, which are difficult to heal.
Calciphylaxis occurs from a buildup of calcium (calcification) inside the blood vessels. The exact cause of this buildup isn't clear, but multiple processes are likely at play.
One contributing factor may be problems with the metabolism of minerals and hormones, including:
The disruption in mineral metabolism is thought to result from kidney disease, but the exact mechanism isn't truly understood.
This is especially true since calciphylaxis can occur in people with regular kidney function. More research is needed to better understand the condition.
Calciphylaxis is considered a rare condition, but the rate is increasing.
Although calciphylaxis is more commonly reported in people receiving dialysis, it may also occur in those who:
People with typical kidney function may sometimes receive a calciphylaxis diagnosis if they also have:
A 2024 study of people from New Zealand and Australia found that the median age of 333 people who reported calciphylaxis while on dialysis was 63. Just over half of them were female.
Currently, an effective treatment or cure for calciphylaxis isn't yet available. Today's treatments focus on:
Treating the related wounds and lesions might include:
A health professional may prescribe medications to treat the wounds and to correct atypical calcium and phosphorus concentrations in the blood. These may include:
The Massachusetts General Hospital finished a clinical trial in 2019 to evaluate whether vitamin K supplements can treat calciphylaxis. Results have yet to be posted.
If medication doesn't control your calcium and phosphorous levels, you may need surgery to remove one or more parathyroid glands (parathyroidectomy). Your doctor may also recommend increasing your dialysis sessions.
Calciphylaxis is a highly fatal condition. The 1-year survival rate is less than 50%. Death is usually a result of complications, such as infections and sepsis.
Successful management of calciphylaxis symptoms is possible, and early diagnosis and treatment can lead to better outcomes even without a cure. The survival rate is expected to improve as more research is performed.
Discuss with your doctor how to reduce your risk for certain risk factors that may increase your chances of developing calciphylaxis.
Ask your doctor about possible involvement in clinical trials for calciphylaxis treatments.
Calciphylaxis often occurs in people with end stage kidney disease and those who are on dialysis. But it can sometimes occur in people with regularly functioning kidneys. Early diagnosis may improve the outcome.
Calcium buildup typically causes it, but other underlying factors might contribute. Common symptoms include painful skin lesions or ulcers.
More research on treatment for calciphylaxis can help improve the survival rates. Talk with your doctor about how to become involved.
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