Lupus nephritis had to understand the common sense

What is the cause of lupus nephritis?
Lupus nephritis is caused by systemic lupus erythematosus (hereinafter referred to as lupus erythematosus) caused by a nephritis. Lupus erythematosus is a very common autoimmune disease, occurs in the growth period of women, has a certain genetic background, in women with elevated hormone (such as pregnancy), ultraviolet radiation, chemical pollution, infection and other incentives susceptible to disease. Lupus erythematosus patients can occur a variety of symptoms such as fever, facial erythema, joint pain, anemia, pleurisy, myocarditis and so on. When lupus erythematosus violations of the kidneys, patients with edema, proteinuria, hematuria or renal insufficiency and so on nephritis symptoms, known as lupus nephritis. The performance of lupus nephritis and general nephritis and no difference, severity varies. Light can be asymptomatic, only in the urine when the urine is found or hematuria, severe cases were the above symptoms.
Lupus erythematosus complicated with nephritis is high, there are clinical symptoms up to 50-70%, if the line biopsy, can be found more than 90% of patients with kidney damage. Therefore, patients with lupus erythematosus should pay special attention to whether the damage to the kidneys, need to regularly check the urine, as soon as possible to find kidney damage, timely treatment. Even if the beginning of the normal urine examination should also be regularly reviewed.
What are the common symptoms of lupus erythematosus? When found the following symptoms, should consider lupus erythematosus, to be a comprehensive examination to early diagnosis:
Hair loss, allergic skin rash; oral, tongue, cheek and other repeated painless ulcers; there are rumors, especially the face of butterfly erythema; light sensitive, Obviously hair loss; cold (especially in winter cold water) after the fingers white or purple, pain, numbness, commonly known as Raynaud's phenomenon; hands, foot petalia, fingertips, toe depression, ulcers, necrosis; repeated or persistent joints Pain, swelling, fever, morning stiffness; unexplained anemia, leukopenia or thrombocytopenia; unexplained pericardial effusion, pleural effusion (except inflammation) and so on.
Young female nephritis patients, the above symptoms should be ruled out lupus nephritis.
Why do patients with lupus nephritis renal biopsy?
Lupus nephritis clinical symptoms vary, more importantly, kidney disease is not the same, renal biopsy can determine the different pathological types. If you follow the previous experience to treat, not only the treatment effect is not good, the disease activity is not controlled, missed the best time to treat, but also because of improper medication to bring unnecessary drug side effects. Therefore, the treatment of lupus nephritis must be "type" to rule, according to the characteristics of kidney damage to choose the best treatment to get the best results. People's Liberation Army Kidney Disease Institute of renal biopsy technology is superb, safe, tens of thousands of cases of renal biopsy patients without an accident, do kidney biopsy can be assured.
What tests do patients need to do with lupus nephritis?
Lupus nephritis patients before and after treatment should do the following laboratory tests: ① blood to understand whether with anemia, leukopenia or thrombocytopenia; erythrocyte sedimentation rate (erythrocyte sedimentation rate), C-reactive protein (CRP); liver and kidney ⑤ CD4, CD8, CD20 and regulatory T lymphocytes; ⑧ urine examination; â ' Doctors will be based on your condition to select the test items, the purpose is to understand the lupus activity and changes in kidney damage in order to adjust the medication.
What are the autoantibodies in the blood of patients with lupus?
Patients with lupus erythematosus due to various reasons for the body to produce antibodies against their own tissue, the medicine called this antibody called autoantibodies. Lupus erythematosus patients with a variety of autoantibodies, common anti-nuclear antibody (ANA), anti-double-stranded DNA antibodies (A-dsDNA), anti-Sm antibodies, anti-ribonucleoprotein antibodies (A-nRNP), anti-SSA antibodies, Antibody, anti-neutrophil cytoplasmic antibody (ANCA), anticardiolipin antibody (ACL) and so on. Detection of these antibodies on the one hand can help diagnose, on the other hand can determine the disease activity should be regularly reviewed.
Which hematological indicators reflect lupus erythematosus activity?
Hypohyaxis (> 50 mm / hour); C-reactive protein and cold globulin increased in response to lupus activity. The expression of C-reactive protein and thrombocytopenia was significantly higher than that of the control group (P <0.05). Lupus erythematosus activity generally have hematological abnormalities, and then only symptoms. Therefore, in the course of treatment usually to regularly detect a variety of hematological indicators, the purpose is to early detection of disease activity, early adjustment of treatment. Do not wait until the symptoms were obvious review, because at this time organ damage is already very serious.
What are the urine tests for patients with lupus nephritis?
Patients with lupus nephritis should usually do 24 hours urine protein quantification, urinary sediment microscopy, urinary white blood cell count and classification, urinary N-acetic acid-β-D glucosaminidase (NAG enzyme), urinary retinol binding protein (RBP), urinary osmotic pressure, urinary C3 / α2-M and urinary protein spectrum analysis, uric acidosis and so on. The purpose is to understand the degree and activity of glomerular and renal tubular injury, is to determine the condition, choose the treatment program to determine the prognosis of the important indicators. Of course, for different patients, check the focus of the project is different, the doctor will make the appropriate judgments.
Can urine tests reflect lupus nephritis?
When the urine check a large number of erythrocyte urine, tubular urine or white blood cells, are prompted lupus nephritis activity or recurrence. Only proteinuria can not be used as an indicator of lupus nephritis activity, but if the dynamic monitoring, urine protein than before the rise or significant hematuria, leukocytic urine should be considered when the activity of nephritis.
How to treat lupus nephritis rationally?
The treatment of lupus nephritis is a more complex clinical problem. If you are a patient with lupus nephritis, please be sure to note the following during treatment:
(1) should be long-term, or even life-long treatment. The disease has a strong genetic background, so far drug treatment can be a good relief of the disease, but can not be completely cured, so long-term medication. Some patients because of fear of drug side effects or listen to medical advice and unauthorized withdrawal, the condition is often repeated.
(2) according to the degree of disease stage of treatment. When lupus erythematosus is active, the renal inflammation is very serious, usually need high doses, several drugs combined therapy (such as hormone combined with mycophenolate mofetil or FK506, etc.) (called induction treatment), the purpose is to quickly control inflammation, prevent the kidney Damage continues to increase. And when the event control is converted to low-dose drug maintenance therapy to prevent recurrence and protection of renal function (maintenance treatment). Long-term use of high-dose drug treatment will bring some complications, but if not maintenance therapy, can cause repeated activity of lupus erythematosus, kidney damage continues to increase, and ultimately may develop for renal failure. Therefore, in the course of treatment, should be based on lupus erythematosus activity, timely adjustment of treatment. Treatment of lupus erythematosus should have a long-term planning, avoid the disease after the free withdrawal, or blind long-term medication.
(3) treatment programs vary from person to person. Lupus nephritis severity varies, there are many types, for different pathological types should take a different treatment program. The current clinical use of high-dose hormone combined with cyclophosphamide intravenous treatment is not suitable for all patients with lupus nephritis. Should be based on specific conditions and pathological type of renal biopsy, under the guidance of a doctor in the selective treatment of drugs. In the long-term maintenance treatment, the combination of Chinese and Western therapy is not only effective, and fewer side effects, the patient can live and work.
(4) attention to prevention and treatment of complications. This is often overlooked. Lupus nephritis patients in the treatment process is prone to a variety of complications, such as infection, cardiovascular complications, femoral head necrosis, severe cases can be life-threatening. The key to reducing complications is the rational use of anti-lupus drugs, regular follow-up early detection and treatment. In the use of high-dose drug treatment, should be relatively isolated, not to public places, pay attention to climate change, fever and other symptoms of infection should be timely treatment.
(5) to prevent recurrence of lupus erythematosus. Any infection, sun exposure, exposure to chemicals or pregnancy can induce lupus erythematosus activity. Female patients should avoid pregnancy before the condition is completely controlled. Such as must be pregnant, but also must be under the guidance of a doctor.
(6) emphasizes the concept of holistic treatment. As lupus erythematosus is a systemic disease, so in the control of lupus nephritis activity, protection of renal function at the same time, should pay attention to other important organs such as heart, lung or brain treatment and functional protection.
In summary, lupus nephritis patients must not listen to swim, accept unscientific treatment. Should choose a regular hospital, according to their doctor's condition characteristics, to develop a long-term treatment plan, and regular review. So as to effectively control the disease, the greatest degree of reduction of drug complications, to maintain a better quality of life and ability to work.
How to better protect your kidneys?
In the treatment of lupus nephritis, the use of immunosuppressive agents to control lupus erythematosus activity is very important, but only concerned about the treatment of lupus erythematosus and ignore the protection of the kidneys is not enough, and ultimately may cause treatment failure, renal insufficiency. In fact, due to lupus activity caused by kidney damage if more serious, even if the lupus is not active, kidney disease can continue to increase, there renal cirrhosis, leading to chronic renal insufficiency. Therefore, in the treatment of lupus nephritis, we must pay attention to the protection of renal function, to avoid renal insufficiency. Some patients due to repeated activities or delayed treatment of lupus erythematosus, may have been in the treatment of varying degrees of renal insufficiency, should also be protected, to avoid further deterioration of renal function. So what factors can aggravate kidney damage?
The first is high blood pressure. Lupus nephritis patients often complicated by hypertension, and hypertension is the biggest risk factor for deterioration of renal function, so lupus nephritis patients must pay attention to monitoring blood pressure, if elevated blood pressure, must be strictly controlled.
Followed by proteinuria. Proteinuria not only reflects the glomerular damage, but also can cause renal tubulointerstitial damage, is one of the risk factors leading to the progress of kidney disease. Reduce urinary protein can reduce the damage to the kidneys, play a role in protecting the kidneys.
Third: nephrotoxic drugs. Some drugs often damage the kidneys, such as sulfonamides, kanamycin, gentamicin, polymyxin B and other antibiotics; traditional Chinese medicine (especially Guanmutong, anti-has) and analgesics. Should avoid the use of such drugs, to minimize unnecessary drugs, so as not to increase kidney damage.
Fourth: infection. In the treatment of lupus nephritis (especially in the first few months of treatment) prone to infection. Infection often leads to recurrence or exacerbation of the disease, so in daily life should pay attention to prevent infection: to avoid crowded public places, to keep the living environment clean and ventilated to reduce the incidence of infection. In the event of infection, should be timely treatment, timely medication.
Fifth: obese. Obesity is a major problem in the global context of public health. Obesity is not only hyperlipidemia, hypertension, coronary heart disease and other risk factors, but also can increase proteinuria, increased kidney damage. If lupus patients with obesity should pay attention to weight loss, to maintain the ideal weight.
Of course, there are other factors, such as heart failure, acidosis, electrolyte imbalance, high blood lipids, etc., in the course of treatment should be corrected.
Lupus nephritis treatment should pay attention to those problems?
(1), in strict accordance with the doctor medication, because the doctor is based on the patient's specific condition, based on clinical experience and the progress of domestic and foreign medicine for your development of the program, must not be free to change; (2), even if the cold and other small hair (3), regularly check the relevant laboratory indicators, especially blood, urine, renal function and immunological indicators. (3), regularly check the relevant laboratory indicators, especially blood, urine, renal function and immunological indicators. (4), appropriate to participate in physical exercise, improve physical fitness, such as tai chi, qigong, walking and other minor fitness exercise; (5), do not believe in advertising and legend, but also more important to participate in physical exercise, (6), to maintain an optimistic and stable emotions, do not overjoyed sadness, to be able to get medical treatment, to have a certain medical conditions of the regular hospital for treatment;
Which patients are suitable for multi-target therapy?
The Institute of Kidney Disease since 2005, the first multi-target therapy for the treatment of severe lupus nephritis, from the concept of renewed awareness of the treatment of immune nephropathy and means of its research results in 2008 officially announced to the world, In the international medical community caused a shock, lupus nephritis patients with the Gospel. Of course, not all patients need to adopt this treatment program, should be based on the nature of renal biopsy lesions to decide whether the need for the use of this therapy.
How to use glucocorticoid correctly?
Glucocorticoids (commonly known as hormones) is the treatment of lupus nephritis basic drugs. The use of hormones has profound knowledge. According to the treatment dose is divided into small, medium and large doses and impact dose, starting dose and drug reduction process, must be based on the disease, vary, under the guidance of a doctor. At the same time should also understand the hormones may bring some side effects: such as infection, high blood pressure, elevated blood sugar, osteoporosis, femoral head necrosis, glaucoma and so on. Therefore, the application of hormones should be under the guidance of physicians, to master the principle of medication, regular follow-up, timely adjustment of the dose, to minimize side effects, should not overuse the side effects of hormones and disabled.
Why do patients with lupus medication for a long time?
Lupus nephritis is a chronic disease, the patient must establish long-term treatment of the idea, the treatment process often takes several years, decades, or even longer, some patients to life medication, perseverance in order to make the disease long-term control. To be experienced doctors, according to the patient's condition to develop a set of practical long-term treatment program, the patient should follow the doctor's prescribed medication. In the long course of treatment, must not be their own thing, casually drug or withdrawal.
Why should patients have long-term follow-up?
Lupus nephritis treatment is a long process, the treatment process must pay attention to follow-up. By regular follow-up can have: (1)
Timely understanding of the degree of disease control, timely adjustment of treatment programs, remission, the drug can be gradually reduced; (2) timely detection of drug side effects; (3)
Early detection of recurrence, clinical symptoms before the emergence of laboratory tests can be early detection of recurrence of the disease in order to get timely treatment. Many patients with exacerbations, and even into the renal insufficiency, and follow-up is not timely or long-term follow-up related to; (4)
To understand whether there are other factors that increase kidney damage. Therefore, we require early treatment (induction treatment period) every January outpatient referral once, stable condition can be followed every 2 to 3 months. Long-term remission can only half a year follow-up.
What is the risk of recurrent lupus?
Patients with their own drug or drug withdrawal easily lead to recurrence. Some patients had a very good condition control, very stable, because of fear of hormonal side effects, and self-medication, resulting in recurrent lupus activity, so that treatment come to naught. Should be noted and warned patients that lupus nephritis

once again, the recurrence of kidney damage once again, the disease repeatedly, not only to the patient's family to bring serious economic burden, but also lead to renal failure, serious and even life-threatening, This painful lesson, the patient must be a warning.