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Renal Lupus Complications


Renal damage is one of the most serious complications of lupus. The majority of people with lupus have some degree of asymptomatic microscopic kidney damage. Fifty percent have clinical renal disease. Kidney damage may necessitate treatment with corticosteroids, cytotoxic agents, dialysis, or renal transplantation.

Renal biopsy can be helpful in making decisions about drug treatments and determining prognosis by assessing the presence of active renal disease versus scarring.

Potential Problems:

  • impaired renal function
  • fluid and electrolyte imbalance

Summary of Potential Renal Lupus Complications

SLE Nephropathy Signs and Symptoms

  • hematuria (as few as 5 RBCs is significant)
  • proteinuria (>1+)
  • sterile pyuria
  • elevated creatinine level (indicates loss of renal function)
  • elevated blood urea nitrogen (BUN)
  • weight gain
  • ankle edema
  • hypertension

Signs and Symptoms Suggesting Renal Failure

  • nausea and vomiting
  • anorexia
  • anemia
  • lethargy
  • pruritus
  • changing level of consciousness

Fluid and Electrolyte Imbalance (Excess Extracellular Fluid Volume)

  • weight gain
  • pitting edema of the lower extremities
  • sacral edema
  • bounding pulse, elevated blood pressure, S3 gallop
  • engorgement of neck and hand veins
  • dyspnea
  • crackles in lungs
  • cyanosis
  • decreased hematocrit
  • urine specific gravity <1.010
  • variable serum sodium level (normal, high, or low), depending on the amount of sodium
  • retention or water retention
  • serum osmolality <275 mOsm/kg

lupus renal

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