Lupus nephritis is inflammation of the kidney that is caused by systemic lupus erythematous (SLE). Also called lupus, SLE is an autoimmune disease. With lupus, the body's immune system targets its own body tissues. Lupus nephritis happens when lupus involves the kidneys. People with lupus nephritis that is causing high blood pressure may need to take medications that lower their blood pressure and can also significantly slow the progression of kidney disease.
Ninety per cent of patients had no damage at 1 year post-diagnosis of SLE; however by year 10, 50% had accrued some damage. Damage accrual was mostly in the neuropsychiatric, renal and musculoskeletal categories. An increase in damage score was associated with a higher risk of death overall. Forty-four patients died during the period of follow-up. Sepsis, cancer and organ failure (cardiac, renal and liver) were the main causes of death in this group of patients.
Two types of blood pressure lowering medications, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have proven effective in slowing the progression of kidney disease. Many people require two or more medications to control their blood pressure. In addition to an ACE inhibitor or an ARB, a diuretic—a medication that helps the kidneys remove fluid from the body—may be prescribed. Beta blockers, calcium channel blockers, and other blood pressure medications may also be needed.
Abatacept and Cyclophosphamide Combination Therapy for Lupus Nephritis, funded under NIH clinical trial number NCT00774852, compares the addition of the experimental medication abatacept to standard cyclophosphamide therapy with cyclophosphamide therapy alone for treatment of lupus nephritis. Immune System Related Kidney Disease, funded under NIH clinical trial number NCT00001979, studies patients with autoimmune diseases of the kidney, including lupus nephritis.