Lupus in the Kidney: What are the dangers and what can be done about it?

Dr Dzifa Dey • January 19, 2022

As part of the awareness raising efforts for the just ended Lupus Awareness month, I would continue with a very important complication of that disease- Lupus nephritis. This is important as its one of the common causes of chronic kidney damage in young people.

What is Lupus Nephritis?

Systemic lupus erythematosus (SLE, or, more commonly “lupus”) is an illness in which the immune system begins attacking its own self. Normally, the immune system helps protect the body from infection or harmful materials. But in patients with an autoimmune disease, the immune system cannot tell the difference between harmful substances and healthy ones, resulting in the immune system attacking otherwise healthy cells and tissue.

Lupus nephritis is one of the most severe complications of lupus. It occurs when SLE causes the immune system to attack the kidneys. The kidneys are important for the body’s function. They remove waste from the blood, which would otherwise accumulate and cause illness and other metabolic disturbances. People with damaged kidneys might have to get regular dialysis. This is a procedure in which waste products in the blood is cleaned by a filtration machine. Some may require kidney transplantation.

Research suggests that about 50% of people with SLE suffer from lupus nephritis. SLE is most common in women ages 20 - 40. Anybody with lupus can potentially have kidney involvement, but people with lupus who have antibodies to double stranded DNA (anti-dsDNA) and low complement proteins ( particularly C3) and patients of African, South American or Asian descent have increased risk and should be watched more carefully for warning signs.

Symptoms

Lupus nephritis symptoms are similar to those of other kidney diseases. They include:

dark urine
blood in urine
foamy, frothy urine
having to urinate often at night
puffy feet, ankles, and legs that gets progressively worse as the day goes along
gaining weight
high blood pressure

Blood Tests

Kidney function tests may show elevated levels of waste products, such as creatinine and urea.

24-Hour Urine protein Collection

This test measures the kidney’s ability selectively to filter wastes. It determines how much protein appears in urine over 24 hours.

Urine Tests

They identify levels of Protein, red blood cells, white blood cells and casts in the urine.

It is important to ascertain if the protein is from renal disease as some drugs that are commonly used in lupus such as ibuprofen or naproxen can cause reversible protein in the urine. Dehydration, excessive exercise, toxins, diabetes and many other conditions can also cause protein urine .

Ultrasound

This is done to look at the size and shape of the kidney and determine whether there is evidence of damage to the kidneys

Kidney Biopsy

Biopsies are the most accurate way to diagnose kidney disease. A long needle is passed through the back and into the kidney and a sample of kidney tissue is taken and analysed for signs and type of damage in the laboratory.

Often, protein in the urine is the first sign of lupus in the kidney. If no other cause is found for it and if the protein does not go away on rechecking it is very vital to get a kidney biopsy as soon as possible. This is because getting treated for lupus nephritis as soon as possible after it is noticed is very important, and without a proper diagnosis the wrong treatment could be given. Even within the spectrum of lupus, there are different forms of nephritis.

It is also essential to get a biopsy to ascertain if there is already kidney damage before treatment is initiated. This determines if there is chronic damage or active disease ad is rated on a scoring system called a chronicity scale. If there is already damage to the kidney, it is more difficult to get the best results with treatment. On the other hand, if there is no chronicity, it suggests that the nephritis was caught early and then chances of success with treatment are very good.

Treatment:

There is no cure for lupus nephritis. The goal of treatment is to keep the problem from getting worse and stopping kidney damage early.

Treatment modalities include:

minimizing intake of protein and salt
lowering cholesterol levels
taking blood pressure medication
using steroids to reduce immune system damage to the kidneys.
other medications that suppress the immune system, such as cyclophosphamide, mycophenolate mofetil, or azathioprine and newer medication like Rituximab.

Complications

The most serious complication associated with lupus nephritis is kidney failure. People with kidney failure will need either dialysis or a kidney transplant. Dialysis may be needed to control symptoms of kidney failure, sometimes for only a while.

Hope for the future

Currently, there are new diagnostic tests being developed in the hopes that in future, kidney biopsies can be avoided, and accurate diagnosis and treatments might be started even earlier. There are also some potentially powerful new treatments in development. There is even some hope that some new drugs that are being made to reduce scarring in tissues might in the future be used to reverse chronicity that has already occurred in the kidney.

In the meantime, the key to dealing with lupus kidney disease effectively is knowing if you might be at higher risk, getting regular monitoring, early diagnosis and treatment.

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Love in Action for People Living with Rheumatic Conditions

By tRi Ghana • February 14, 2026

This Valentine’s month, learn how compassion, awareness, and community support can improve the lives of people living with rheumatic conditions in Ghana.

A person sleeping peacefully, symbolizing the connection between sleep and managing RA symptoms.

Sleep & Rheumatoid Arthritis — Why It Matters This February

By tRi Ghana • February 2, 2026

February is Rheumatoid Arthritis Awareness Month. Learn how sleep affects rheumatoid arthritis, and practical tips to improve rest and quality of life.

Wishing Everyone Good Health and an Amazing 2026.

By Prof Dzifa Dey • January 1, 2026

tRi Ghana wishes you a healthy 2026! Prioritize your wellbeing with our latest updates and community initiatives. Here’s to an amazing year of wellness and growth.

Santa rocking out and playing a Christmas tree like an electric guitar.

Christmas, Compassion, and Living with Rheumatic Conditions

By tRi Ghana • December 25, 2025

Raising awareness and compassion for people living with rheumatic conditions in Ghana this Christmas season.

International Men’s Day

By tRi Ghana • November 19, 2025

On International Men’s Day , we take a moment at The Rheumatology Initiative (tRi Ghana) to recognise an often-overlooked group: men living with autoimmune rheumatic diseases . Whether it’s rheumatoid arthritis, lupus, or other chronic conditions, men face unique challenges in both diagnosis and support. Breaking the Silence on Male Rheumatic Conditions Autoimmune diseases are often perceived as “women’s diseases,” but men are affected too. This misconception can delay diagnosis, as symptoms may be dismissed or misattributed. On this special day, tRi Ghana calls on everyone to raise awareness about rheumatic conditions in men, encouraging early screening and better education. The Importance of Support Living with a chronic disease is difficult—physically, emotionally, socially. For men, social stigma or cultural expectations about strength may make it harder for them to ask for help. tRi Ghana provides vital support through peer groups, education, and information, empowering men to seek help, share their experiences, and build resilience. tRi Ghana’s Role Since our founding in 2012, tRi Ghana has offered education, advocacy, and research into autoimmune rheumatic conditions. Our support groups, such as Rheusolute , create safe spaces for people—including men—to connect, share stories, and learn management strategies. Our patient assistance programme also helps with financial and medical support, covering discounted medication and free medical consultations to ensure all patients—regardless of gender—receive care. Encouraging Men to Advocate for Their Health On International Men’s Day, we urge men to listen to their bodies: if you experience persistent joint pain, stiffness, or fatigue, don’t ignore it. Advocate for your health by seeking a rheumatologist, asking for blood tests, and joining a support network. At tRi Ghana, we welcome you with open arms. Highlighting Role Models This day, we celebrate men who courageously live with rheumatic disease and also those who support loved ones in their journey. Your bravery, openness, and perseverance inspire others—and drive our work. How You Can Help Raise awareness : Share stories of men affected by rheumatic conditions on social media, using #InternationalMensDay and #RheumaticHealth . Support tRi Ghana : Donate to fund medication, research and patient support. Join our community : Attend support groups for men, or bring a male friend or family member to a session. We meet monthly and welcome all. A Message of Hope To the men living with these conditions: you are not alone. tRi Ghana stands with you. On International Men’s Day, let’s acknowledge your strength—and commit to a future where your health is seen, valued, and supported.

Rheuma Connect: Transforming Rheumatology Care in Ghana

By tRi Ghana • October 14, 2025

tRi Ghana introduces Rheuma Connect, Ghana’s first digital platform for managing rheumatic and autoimmune diseases. Download the app and take charge of your health.

Raising Awareness on Rheumatic Diseases in Ghana

By tRi Ghana • September 1, 2025

Rheumatic and musculoskeletal diseases are more prevalent in Ghana than many realize, often leading to chronic pain and disability. At The Rheumatology Initiative (TRI) Ghana, our mission is to bring hope and support to those affected by these conditions. Through education, advocacy, and patient support, we are working to improve the quality of life for countless individuals and their families. Rheumatic diseases, such as arthritis, can impact anyone, regardless of age or background. A lack of awareness often leads to late diagnosis and inadequate treatment, compounding the challenges faced by patients. Our work focuses on closing this gap by providing accurate information, connecting patients with expert care, and offering support groups where individuals can share their stories and find strength in community. By raising awareness, we can help people recognize symptoms earlier and seek the medical attention they need. We advocate for better access to rheumatological care across Ghana and work with healthcare professionals to enhance their knowledge and skills. Your support, whether through volunteering, donations, or simply sharing our message, is crucial. Together, we can build a future where rheumatic diseases are no longer a silent struggle, but a manageable condition for all.

Understanding and Managing Rheumatic Diseases in Africa

By tRi Ghana • August 11, 2025

Rheumatic diseases, which include conditions like rheumatoid arthritis, are a significant health challenge across Africa. They are often misunderstood and underdiagnosed, leading to delayed treatment and poor health outcomes. Educating the public and healthcare professionals is a crucial first step in addressing this issue. Awareness campaigns and educational programs are essential for helping people recognize the symptoms and seek help early. For individuals living with these conditions, support extends beyond medical treatment. The chronic and often debilitating nature of rheumatic diseases means that patients also need emotional, psychological, and social support . A holistic approach to patient care is vital, providing resources and guidance to help individuals manage their condition and maintain a good quality of life. This can include establishing support groups where patients can connect with others who understand their journey, as well as providing access to patient assistance programs for treatment. The work of dedicated organizations is key to building this support infrastructure. By bringing together a diverse team of professionals, from doctors and counsellors to community leaders, they can create a comprehensive network of care. Their efforts not only raise awareness but also build a resilient community for patients, offering hope and a sense of belonging. The ultimate goal is to empower individuals to live full and active lives, despite their diagnosis. To learn more visit: www.trighana.org

Living with Juvenile Idiopathic Arthritis – A Guide for Ghanaian Families

By tRi Ghana • July 24, 2025

For families in Ghana, receiving a diagnosis of Juvenile Idiopathic Arthritis (JIA) can feel overwhelming. Questions about treatment, lifestyle changes, and the future often come all at once. At tRi Ghana, we believe that knowledge is empowerment — and that children with JIA can thrive when families have the right tools and support. The Emotional Journey Hearing that your child has a chronic illness can be emotionally challenging. It’s normal to feel fear, sadness, or even guilt — but remember: JIA is nobody’s fault . Support from other parents and patient groups can make the journey less isolating. Treatment Options While there’s no cure for JIA, treatments can control symptoms and prevent long-term joint damage. These may include: Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling Disease-modifying antirheumatic drugs (DMARDs) to slow disease progression Biologic agents for children who don’t respond to other treatments Physical therapy to maintain flexibility and strength Treatment plans should be tailored to each child’s needs, with regular check-ups to monitor progress. Daily Life Tips for Children with JIA Stay active – Low-impact activities like swimming or cycling keep joints moving. Balanced diet – Anti-inflammatory foods such as fruits, vegetables, and omega-3-rich fish can help overall health. Good sleep routine – Rest is essential for healing and energy. School support – Teachers should understand your child’s needs, including rest breaks or adapted physical education. The Role of Family and Community Living with JIA isn’t just about medical care — it’s about creating a supportive environment where the child feels capable and included. Family encouragement, community understanding, and peer friendships all contribute to better outcomes. JIA Awareness in Ghana In many Ghanaian communities, awareness is still low. By talking openly about JIA, sharing information on social media, and attending tRi Ghana’s support events, you’re helping to break the silence and stigma. Final Message A JIA diagnosis is not the end of childhood dreams. With proper care, children can play, learn, and grow just like their peers. This July, as we mark Juvenile Arthritis Awareness Month , let’s unite to ensure no child’s potential is limited by delayed diagnosis or lack of support.

Understanding Juvenile Idiopathic Arthritis – Shining a Light This July

By tRi Ghana • July 3, 2025

Every July, the world comes together to raise awareness for Juvenile Idiopathic Arthritis (JIA) – a chronic condition that affects children and young people under the age of 16. In Ghana, awareness is especially important because rheumatic diseases are often misunderstood, underdiagnosed, or mistaken for temporary joint injuries. What Is Juvenile Idiopathic Arthritis? Juvenile Idiopathic Arthritis is the most common type of arthritis in children. “Idiopathic” means the cause is unknown, and “arthritis” refers to inflammation of the joints. JIA isn’t just about occasional aches — it’s an autoimmune condition where the immune system mistakenly attacks the body’s own tissues, leading to pain, swelling, and stiffness. Common Symptoms Persistent joint pain, swelling, or warmth Morning stiffness that improves during the day Fatigue and low energy Eye inflammation (in some types of JIA) Reduced physical activity or reluctance to walk/play These symptoms may come and go, making it difficult for parents and doctors to identify the condition early. Why Early Diagnosis Matters If left untreated, JIA can cause joint damage, growth problems, and in some cases, long-term disability. Early diagnosis and treatment are essential for: Preventing irreversible joint damage Maintaining a child’s mobility and quality of life Reducing the risk of complications such as vision problems At tRi Ghana, we advocate for early screening , especially when symptoms persist for more than six weeks. Breaking the Myths in Ghana Many people believe arthritis is a condition for the elderly — this misconception leads to delayed treatment for children. Some also turn to unverified herbal remedies before seeking medical advice, which can delay effective care. Education is the first step in changing this narrative. How You Can Help This July Spread the word about JIA in your community. Encourage parents to seek medical advice early if their child has persistent joint issues. Support tRi Ghana’s awareness programs through donations or volunteering. This July, let’s commit to making sure every child with JIA gets the diagnosis, treatment, and support they need to live a full and active life.