Because lupus patients are highly susceptible to infection, we often have to deal with urinary tract infections (UTIs). UTIs and kidney infections are the result of an organism/germ entering the body and infecting the urinary tract. Usually. UTIs affect only the urethra, bladder and ureters. Untreated, a UTI can spread upwards, affecting the kidneys. (Kidney infections shouldn’t be confused with lupus nephritis – More about that later.) These infections are usually treated with antibiotics, plenty of fluids and the old kitchen remedy of gallons of cranberry juice. (Which is extremely helpful in reducing the pain and discomfort!)
“Nephritis” means inflammation of the kidneys. When the dysfunctional immune system of the lupus patient creates antibodies that attack and damage the delicate cells of the kidney, kidney dysfunction and even kidney failure can occur. Unfortunately, the kidneys are prime targets for lupus, along with the brain, skin and joints. According to a Johns Hopkins study (1*), 50% of lupus patients will suffer from “clinically relevant nephritis." This nephritis will necessitate treatment ranging from medication and diet changes to dialysis or even kidney transplantation for the most serious cases.
Kidney involvement in lupus can sometimes be very tricky to diagnose. Many times, lupus patients are unaware that they have lupus nephritis because they have no symptoms at all. Other subtle signals that the kidneys might be affected by lupus are easy to notice if you know what to look for: sudden weight gain, dark urine that foams in the toilet (a possible indication of protein or ketones in the urine), a sudden increase in blood pressure, or sudden swelling in the legs, ankles and feet.
Another symptom that is often missed is having to get up in the night to urinate. While this might be easily dismissed as a symptom of lupus nephritis, blood flow to the kidneys increases when we lie down. If the kidneys are dysfunctional, this increase in blood flow is often enough to increase kidney performance to the point that the kidneys only have peak urine production at night, causing the person to need to get up to empty the bladder.
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