Vanessa’s Journey with Lupus Nephritis

By Vanessa Rios

At the age of 14 I began dealing with a new complication of SLE and that is Nephritis. Lupus Nephritis is a Kidney disorder and it affects 3 out of 10,000 people; however, in children with SLE the statistics go up to 50%. What happens is that the Lupus begins to attack healthy kidney tissue causing inflammation of the kidney. When this happens protein begins to pass through the kidney tissue and cause scarring. Severe scarring of the kidneys causes them to eventually shut down.

While this is happening however, there are no real symptoms. You don’t feel sick at all, there are no warning signs; I didn’t feel anything I felt great. (When and if this continues untreated some people may develop high blood pressure or swelling in various parts of the body). I had a really good doctor and she was thorough; she took nothing for granted, and she was able to see the spilling of protein in my urine.

I had my first Kidney biopsy at the age of 14. In fact, the Nephrologist who did my first kidney examination and biopsy is still my doctor today. He is an awesome doctor, who genuinely cares about his patients; he’s like part of my family.

The biopsy came up positive for active Lupus Nephritis and again I was given steroid therapy to quickly bring the Lupus under control. I thought, here we go again, something else, I’m so tired of this already, but I also braced myself for the fight.


First a regular urinalysis is done monthly, if any of those results return with elevated protein levels and or are positive for blood  most doctors go on to a second course of testing to rule out nephritis.  The test physicians use in diagnosing and catching the onset of nephritis in its earlier stages is by having the patient submit a 24 hour Urine Culture. This is done by having the patient collect all the urine within a day, so the first one (early morning urine) is let go and then the second catch until the first of the next morning is collected in a sterile dark colored container which is usually given by the hospital lab.  This is then sent to the lab and tests for protein levels and or blood are done on the sample.


When and if there are signs of Nephritis the first thing most Rheumatologist and Nephrologist would suggest is to reverse the inflammation and active Lupus quickly, hence Prednisone (corticosteroids) will be prescribed as it has the quickest reaction time.  In many cases this is enough to heal the kidney and keep the Lupus under control.  However, remember corticosteroids can only be used for short periods of time.  So while this may be effective in the short-term if the nephritis keeps coming back other avenue may need to be explored.

Cytoxan (cyclophosphamide) a type of cytotoxic medication used for various types of cancers and also considered an immunosuppressant can also be used to treat Lupus Nephritis as it treats the overactive immune system causing damage to health kidney tissue.  Unfortunately, like in the case of most cytotoxic drugs, it harms healthy cells as well and can cause the patient to experience similar side effects such as: nausea, vomiting, diarrhea and or hair loss.

One of the new types of drugs targets certain blood cells found to be responsible for autoimmune responses and certain cancers; Rituxan (rituximab). Very similar to Cytoxan it is often used to treat various Cancers and subsequently shares many of the same side effects as well.

Those are a few of the most common treatments used to treat Nephritis; I however, lost the battle and therefore lost the function of my kidneys.  I also want to specify, though, that I was diagnosed with Lupus over two decades ago and that today is a new day.  Doctors are more aware of what to look for and how to treat it.  My best advice is to get educated and take control of your health.  Learn what’s out there and available to you; what works wonders for some may not work for you so also be careful of those that would try to fit you in a box.

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