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Kidney Involvement and Lupus

Posted Mar 19 2009 3:20pm

I was reading the chat transcript in the LFA website and I found the chat quite enlightening. Here are some of the Q&A that I found quite helpful.

I have been spilling +1 protein in my urine for 6 years. My 24 does not ever seem to be over 600mg. My doctor isn’t concerned because my creatinine is always normal. But I’m worried. Should I request a biopsy or just continue to watch this? — Detroit, MI

Dr. Rovin
The fact that your creatinine has been normal and unchanged over several years suggests that you have not suffered significant kidney damage, which is good. However, even 600 mg of protein a day could predispose you to progressive kidney injury. Your doctor should try to lower this proteinuria, preferably below 300 mg/day. This could be done with blood pressure control, low salt diet, and they use of ACE inhibitors or ARBs. If these maneuvers are not successful a kidney biopsy could be warranted to see exactly what is going on in the kidneys, and if this needs accelerated immunosuppression.

How often should I get my urine tested? Sometimes my urine is a darker color (like weak tea) should I be worried about this. I don’t have other symptoms.

Dr. Rovin
If you have SLE, I would recommend that your doctor check your urine for protein and blood at least once a year. If you have had nephritis with your lupus then I would suggest checking the urine at least twice a year, but I would be more comfortable if it was done quarterly. This would hopefully alert the physician to issue early in the course so that treatment could be started quickly to preserve kidney mass. Dark urine generally simply reflects concentration of the urine which is a normal function of the kidneys depending on your state of hydration. If you were to see blood in the urine, which is not subtle, then tell your doctor. Similarly if your urine has lots of bubbles in it, it could be a sign of protein so that also deserves a closer look.

To read more of the transcript and know who Dr. Rovin here you can go to this link.

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