Category Archives: Lupus

Dr. Spry, In May, 2017 my GFR was 70.1. I do not have diabetes. I have all the symptoms of lupus with, possible diagnosis. I have scleroderma and Sjogren’s as well. I have also tested positive for anti-phospholipid syndrome, with no blood clots to date. I started having kidney pain about two months ago. My specialist ran my labs again and my GFR is now 56. It has fallen 14 points in almost exactly two years. She seemed unconcerned. My mom also has kidney disease. Should I be concerned? I was considering going to a nephrologist because my health insurance does not require referrals. Any advice is appreciated.

It would be important to also do a urine test for blood, protein and infection to look for kidney disease. The urine should also be examined under the microscope to look for red blood cells and casts. I am unable … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Lupus

Sir, I have lupus nephritis. I checked my routine blood test and the result was: Creatinine 5.1, Urea 183, WBC 2500, Hgb 7.0. I’m on medicines such as Solumedrol & Colstim Aciloc Alphadol 0.25mg. Please tell me a good treatment for me?

I am unable to recommend treatment without performing a complete history and physical examination.  I am unable to make a specific diagnosis based on the information that you present.  You may have lupus nephritis but your kidney tests are very … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Lupus, Nephrologist

Thank you so much, Dr. Spry. I have Lupus, Sjogren’s, and Hashimoto’s. I got bloodwork back the other day and my eGFR was down from 75 May 2, to 66 Sept. 1. My (random) urine was checked and Albumin was 40.8% & Total Protein was 23.3. UAlbumin 40.8% (9.5 mg/dl) UAlpha1 59.2% (13.8mg/dl). Urine Creatinine 189.5 mg/dL. My SERUM BUN/Creatinine Ratio was Low @ 8. SERUM Creatinine is 0.96 (rising). The nurse indicated that there was nothing remarkable about these values. My father was on dialysis for years and passed at 63. Glomerulonepritis. I am 57 now. I think these values warrant further investigation, as kidney disease has affected several other paternal relatives as well. But I don’t know how to go about doing anything about it. I am concerned about Lupus Nephritis, also. I have Anemia of Chronic Disease, and Polyclonal Hypergammaglobulinemia dx through a bone marrow aspirate nearly 20 years ago. But no one ever knew what to do with that information. I’m very worried about my kidneys. Can you help me understand if my concerns are warranted? Thanks again, in advance.

When interpreting the estimated glomerular filtration rate (eGFR), we use normal as being anything greater than 60 milliliters per minute per 1.73 meters squared. Hence, the laboratory cannot reliably tell the difference between 75 and 66. These numbers within the … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Dialysis, GFR, Glomerulonephritis, Kidney-Related Health Questions, Laboratory Testing, Lupus

Should a person take Cellcept with kidneys functioning at 100%? My spouse is a lupus pt and was recently prescribed this medication due to swelling in his legs and feet. I am doing some research on this medication and very concerned about him taking it. He was prescribed 500mg a day for 2 weeks, then two tablets a day for 2 weeks, then 3 tablets a day. I am concerned about damage to his kidneys from the use of this medication and also concerned about immunosuppression.

Cell Cept (mycophenolate mofetil) is a immunosuppressive medication used in lupus patients to prevent damage to major organs such as his kidneys.  I am not able to make a specific diagnosis based on the information that you present.  I am … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Lupus, Medication and Kidney Disease, Medication and Kidney Function, Symptoms and Side Effects, Treatments

Is there a way to determine what caused your kidneys to lose their function? Can a biopsy let you know if it is diabetes or high blood pressure or lupus? Does knowing what exactly caused the CKD help with the treatment to protect further loss of kidney function. When would you recommend a biopsy?

A kidney biopsy will yield a specific diagnosis as to the cause of kidney disease in most circumstances.  Only a nephrologist can determine if you need a kidney biopsy.  I suggest that you consult with a nephrologist.  A kidney biopsy … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Lupus

I recently had a biopsy done on my left kidney. The pathology report diagnosis is: Sclerosing immune complex glomerulonephritis with 90% global glomerulosclerosis and Severe interstitial fibrosis and tubular atrophy (90%) (It also says the morphologic findings are most suggestive of an advanced Sclerosing lupus nephritis (class VI), which I tested neg for lupus) My question is, is this diagnosis for both kidneys? I messaged my nephrologist, but she didn’t answer my question. I am stage 3, with my eGFR NON-AFR. AMERiCAN being 38 (>OR + 60 mL/min/1.73m2) I’m confused, I don’t know what to do. She started me on the highest dose of Lorsartan with HCTZ, recommended a dietician and made an appointment for 3 months. Thank you for any information.

The description you provide suggests that whatever this disease is (the pathologist thinks that this looks like systemic lupus erythematosis) has caused advanced scarring of your kidney, which also suggests a very poor prognosis.  This disease would be present in … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Kidney Biopsy, Kidney-Related Health Questions, Lupus

My GFR has been in the 50’s for the past few years. I strength train and teach numerous (10) fitness classes per week. Female, weight 94, 5’2″, at 54 yrs of age. Just wondering how much protein per day is advisable? I don’t have high blood pressure, cholesterol, or diabetes, though wondering if there’s a connection of lichen planus and kidney disease? My ANA is positive for Lupus, homogenous pattern, though rheumatologist says I have fibromyalgia. Please let me know your thoughts.

I generally recommend that patient with some chronic kidney disease (CKD) limit protein intake to less than 1.5 grams of protein per kilogram of body weight per day.  Hence, for you that would be about 65 grams of protein per … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Lupus, Medication and Kidney Function, Treatments

My Rheumatologist just advised me that my kidneys are “struggling.” He changed my medication, told me to push fluids and wants to recheck my blood work in 3 months. My eGFR was 43.08; BUN 24.0; Albumin 4.5 and Potassium 5.2. I reviewed my labwork since 2012 and my eGFR has been declining since then (I moved to stage 3 levels 4/2015). Should I see a Nephrologist or wait and see how my levels respond to the change in medication? I have Rheumatoid Arthritis and Lupus.

I suggest that you review your concerns with your rheumatologist.  I am unable to make a specific diagnosis based on the information that you present.  I suggest that you also have urine testing for blood, protein and infection to determine … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Lupus

I have lupus, & have had three kidney stones in an 18 month period. Two were golf ball size & required surgery. I now have incontinence frequently. My cousin just had a kidney transplant. How would I find out if I have a kidney disorder?

If you have had two kidney stones, this is a type of kidney disease.  In order to determine if you have chronic kidney disease (CKD), I suggest that you have a blood (serum) creatinine measured and also have urine testing … Continue reading

Posted in Ask the Doctor, Kidney Stones, Kidney-Related Health Questions, Lupus

Do you have any thing on lupus and the kidney? and is there any other things that can be done other than biopsy?

Systemic Lupus Erythematosis (SLE or Lupus) can cause glomerulonephritis in the kidney.  You can review the information available at our web site to review the causes and evaluation of glomerulonephritis at:   https://www.kidney.org/atoz/content/glomerul There are at least six types of lupus … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Lupus