Lupus Nephritis Clinical Presentation

Lupus nephritis is a serious complication of systemic lupus erythematosus (SLE; lupus) and is a major predictor of poor outcome. Most commonly, lupus nephritis develops early in the course of disease, but it can be a late complication as well (called delayed lupus nephritis [DLN]). Mortality is higher for lupus patients who develop nephritis than for those who do not.

Patients with active lupus nephritis often have other symptoms of active systemic lupus erythematosus (SLE), including fatigue, fever, rash, arthritis, serositis, or central nervous system (CNS) disease. These are more common with focal proliferative and diffuse proliferative lupus nephritis.

Some patients have asymptomatic lupus nephritis; however, during regular follow-up, laboratory abnormalities such as elevated serum creatinine levels, low albumin levels, or urinary protein or sediment suggests active lupus nephritis. This is more typical of mesangial or membranous lupus nephritis.

Symptoms related to active nephritis may include peripheral edema secondary to hypertension or hypoalbuminemia. Extreme peripheral edema is more common in persons with diffuse or membranous lupus nephritis, as these renal lesions are commonly associated with heavy proteinuria.

Other symptoms directly related to hypertension that are commonly associated with diffuse lupus nephritis include headache, dizziness, visual disturbances, and signs of cardiac decompensation.

High Blood Pressure and High Creatinine

High blood pressure (hypertension) is designated as either essential (primary) hypertension or secondary hypertension and is defined as a consistently elevated blood pressure exceeding 140/90 mm Hg.

High blood pressure is called "the silent killer" because it often causes no symptoms for many years, even decades, until it finally damages certain critical organs.

Poorly controlled high blood pressure ultimately can cause damage to blood vessels in the eye, thickening of the heart muscle and heart attacks, hardening of the arteries (arteriosclerosis),hypertensive nephropathy, kidney failure, and strokes.

How to lower high creatinine effectively?

Serum creatinine is an effective measure for kidney functions. In the treatment of kidney disease, the patients are very concerned as to how to lower their elevated creatinine and stop further damage on their kidneys. The complexity of kidney diseases means that a comprehensive treatment system is required so as to control the illness condition. The people need to know the severity of high creatinine and treat their disease positively.

Work with your doctor to develop a personalized diet that is low in protein. The amount of protein you eat on this diet depends on how much you weigh, so do not attempt this diet on your own. You will also need to test frequently to be sure that the creatinine levels in your urine are increasing and the levels in your blood are decreasing. This indicates that the creatinine is being excreted properly. Doctors will prescribe Lasix, a strong diuretic, to promote urination. This is another reason a person with high creatinine levels must drink plenty of water.

We need to know why creatinine increases. Creatinine as a wasteful product should normally be discharged out of the body by the kidneys. The medicines played good role in reducing the excessive toxins such as creatinine, urea nitrogen, uric acid, etc. However, this will not help for improving or injuring the lesioned renal tissues. In long-term developing course, with scarring on the kidneys worsening and kidney condition deteriorating, serum creatinine keeps on rising and efficacy of the medicines will get reduced. Such risk factors as inflammations, cold, infections can cause rapid deterioration of kidney function and worsen the illness condition.

High Blood Pressure and Kidney Disease

How does high blood pressure hurt the kidneys?

High blood pressure makes the heart work harder and, over time, can damage blood vessels throughout the body. If the blood vessels in the kidneys are damaged, they may stop removing wastes and extra fluid from the body. The extra fluid in the blood vessels may then raise blood pressure even more. It's a dangerous cycle.

High blood pressure is one of the leading causes of kidney failure, also called end-stage renal disease (ESRD). People with kidney failure must either receive a kidney transplant or have regular blood-cleansing treatments called dialysis. Every year, high blood pressure causes more than 25,000 new cases of kidney failure.

How can blood pressure be controlled?

People with prehypertension or high blood pressure should :

• maintain their weight at a level close to normal.
• eat fresh fruits and vegetables, grains, and low-fat dairy foods.
• limit their daily salt, or sodium, intake to 2,000 milligrams. They should limit frozen foods and trips to fast food restaurants. They should read nutritionlabels on packaged foods to learn how much sodium is in one serving. Keeping a sodium diary can help monitor sodium intake.
• get plenty of exercise—at least 30 minutes of moderate activity, such aswalking, cycling, or swimming, most days of the week.
• avoid consuming too much alcohol. Men should have no more than two drinks—two 12-ounce servings of beer or two 5-ounce servings of wine or two 1.5-ounce servings of hard liquor—a day. Women should have no more than a single serving a day because differences in the way foods are broken down in the body make women more sensitive to the effects of alcohol.

http://www.kidneyabc.com/hypertensive-nephropathy/

Secondary Chronic Kidney Disease--Hypertensive Nephropathy

Even if people have had high blood pressure, they usually do not know what complications would happen in a few years. Heart disease may be the most concerned for them, but they always ignore the most fatal one—kidney disease (Hypertensive Nephropathy ). High blood pressure will narrow and harden main artery and the blood capillary. In kidneys, a large number of tiny blood vessel balls are in charge of blood filtration. Little tiny blood vessels cannot bear the high pressure, so they will become narrow in order to reduce the blood infusion. As a result, it will directly lead to the lack of blood and oxygen. Renal inflammation would occur to hurt kidney tissues.

This damaged process would last for a long time and gradually hurt kidneys. So in most time, people would have no consciousness for no obvious symptoms present in the body. "I have a strong urination at night. In the beginning, I though it may be caused more water input. Now I know it is a sign of hypertensive nephropathy."

What are the specific physical performance of hypertensive nephropathy? Specific performance:

Early nocturia increased, followed by proteinuria, individual cases have occurred hematuria, usually without low back pain. Often associated with atherosclerotic retinopathy, left ventricular hypertrophy, coronary heart disease, heart failure, cerebral arteriosclerosis, cerebral vascular accident. Malignant hypertension is associated with cardiovascular complications, the rapid development of the disease, proteinuria and hematuria, renal function rapidly diminished, and even uremia.

High blood pressure can cause complications of the heart, brain, kidney and other organs, can lead to high morbidity and mortality, 10% of the hypertensive patients died of renal failure. Therefore, high blood pressure and kidney disease is one pair of real "loser".

Hypertensive nephropathy to patients is a very serious, so in order to reduce such damage, must be timely treatment.

Could Folic Acid Cause Hypertensive Nephropathy?

What is Hypertensive Nephropathy

Hypertensive Nephropathy is a medical condition in which chronic high blood pressure causes kidney damages. As the name suggests, hypertensive nephropathy is caused by high blood pressure. Why hypertension harms kidneys? Blood pressure means the force of blood against the walls of the blood vessels. Extra fluid in the body or the narrowed blood vessel will raise the blood pressure.


What is Folic acid

Folic acid has active ingredients of folic acid. It is used in therapeutic drug levels, heart injury, folate deficiency, rheumatoid arthritis, anemia. Common side effects of Folic acid include nausea, fatigue, weakness, fever, breathing difficulty.

On Oct, 18, 2012: 80,246 people reported to have side effects when taking Folic acid. Among them, 12 people (0.01%) have Hypertensive Nephropathy.Gender of people who have Hypertensive nephropathy when taking Folic acid :

Age of people who have Hypertensive nephropathy when taking Folic acid :

Top conditions involved for these people:

• Wheezing
• Paroxysmal nocturnal haemoglobinuria
• Haemoglobin abnormal
• Diabetes mellitus non-insulin-dependent
• Thyroidectomy

High Blood Pressure (Hypertensive Nephropathy)

Hypertension is a condition when your blood pressure is recorded consistently at the level of 140/90 mmHg or higher. Most of the time, hypertension does not show any symptoms. The problem is that Hypertension is not just a cause of kidney disease, but it's also a result of damage created by the kidney disease. High blood pressure makes your heart work harder and damages your blood vessels. As the blood vessels in your heart become damaged, they lose their effectiveness in screening the wastes from your body. This increases the fluids in your body and increases your blood pressure even more.

The damage of the blood vessels in your kidneys due to high blood pressure is what is known as Hypertensive Nephropathy.

What are the symptoms of Hypertensive Nephropathy?

If high blood pressure runs in your family, the presence of the disease seems to increase chances of developing kidney disease. Symptoms of kidney disease due to high blood pressure include:

• A need to urinate more often, especially at night
• Decrease in amount of urine or difficulty urinating
• Edema (fluid retention), especially in the lower legs

What are the Types of Hypertensive Nephropathy?

There are 2 types of hypertensive nephropathy, namely benign nephrosclerosis and malignant nephrosclerosis. Benign nephrosclerosis is most present in people over 60 years old while the rare malignant nephrosclerosis occurs only in 1 to 5 percent of people with hypertension.

Malignant nephrosclerosis only occurs in a case of hypertension with diastolic blood pressure exceeding 130mm Hg. This is present in patients that already have an existing kidney disease that developed into malignant hypertension.

How is Hypertensive Nephropathy prevented?

• To prevent hypertension-related kidney damage:
• Keep your blood pressure below 130/80
• Have your blood pressure checked regularly
• Maintain a proper diet
• Take any medications prescribed by your doctor

Stage 4 Chronic Kidney Disease (CKD)

A person with stage 4 chronic kidney disease (CKD) has advanced kidney damage with a severe decrease in theglomerular filtration rate (GFR) to 15-30 ml/min. It is likely someone with stage 4 CKD will need dialysis or a kidney transplant in the near future.

As kidney function declines waste products build up in the blood causing a condition known as “uremia.” In stage 4 a person is likely to develop complications of kidney disease such as high blood pressure, anemia (a shortage of red blood cells), bone disease, heart disease and other cardiovascular diseases.

Symptoms that are experienced in stage 4 include:

Fatigue: Feeling tired is common for people with CKD and is often caused by anemia.

Too much fluid: The kidneys may lose their ability to control how much fluid stays in the body. A person may notice swelling (edema) in their lower legs, hands or face around the eyes. With too much fluid someone, could even feel short of breath.

Urination changes: Urine may be foamy if there is protein in it, or dark orange, brown, tea colored or red if it contains blood. A person may urinate more or less than normal, or get up at night to go to the bathroom.

Kidney pain: Most people with CKD do not have kidney pain, but with some kinds of kidney problems, such aspolycystic kidney disease (PKD) or infections, they may have pain in their back where the kidneys are located.

Sleep problems: Some people have trouble falling asleep or staying asleep. Itching, muscle cramps or restless legs can keep them awake.

Nausea: Vomiting or feeling nauseated may occur with CKD.

Taste changes: Food may not taste like it usually does, or may have a metallic taste.

Uremic breath: As urea builds up in the blood, it may be detected in the breathing causing bad breath.

Loss of appetite: People in this stage may not feel like eating, and some people report having a metallic taste in their mouth or bad breath.

Difficulty in concentrating: Having trouble balancing a checkbook or focusing on reading the newspaper can happen with CKD.

Nerve problems: Numbness or tingling in your toes or fingers is a symptom of CKD.

Chronic kidney disease (CKD) happens if your kidneys have been damaged. Kidneys can become damaged from a physical injury or a disease like diabetes or high blood pressure. Once your kidneys are damaged, they are not able to filter blood or do their other jobs well enough to keep you healthy. Some of the important jobs kidneys do:

• Filter blood
• Balance your body's fluids
• Regulate hormones
• Help keep blood pressure under control
• Keep bones healthy
• Help make red blood cells

Even if you get treatment in stage 4 and are careful about your health, your kidneys may still fail. Kidney failure happens when:

• 85-90% of kidney function is gone
• GFR falls below 15
• Kidneys don't work well enough to keep you alive

There is no cure for kidney failure, but with treatment it is possible to live a long, fulfilling life. Having kidney failure is not a death sentence. People with kidney failure live active lives and continue to do the things they love.


Is Kidney Failure in Your Chronic Kidney Disease(CKD) Future? Make An Estimation of Your Current CKD. http://www.kidneyabc.com/CKDQuestionnaire.html