Overview
Diagnosis
Tests used to diagnose lupus nephritis include:
• Blood and urine tests, including 24-hour urine collection, to assess kidney function
• Kidney biopsy, where a small sample of kidney tissue is taken and examined in a lab. This confirms lupus nephritis and helps determine disease severity. Multiple biopsies may be done over time
Care at Mayo Clinic
Mayo Clinic specialists provide guidance and care for lupus nephritis management
Treatment
There is no cure for lupus nephritis. Treatment focuses on:
• Reducing or eliminating symptoms (achieving remission)
• Preventing disease progression
• Preventing recurrence of symptoms
• Maintaining kidney function to avoid dialysis or kidney transplant
Supportive treatments
Supportive measures that help protect kidney function include:
• Diet changes, such as limiting protein and salt intake to ease kidney workload
• Blood pressure medications, including ACE inhibitors and ARBs, to control blood pressure and reduce protein leakage into urine
• Diuretics to remove excess fluid
Medicines
Severe lupus nephritis may require medications that suppress the immune system. Often, multiple medicines are used together, and treatments may be adjusted to reduce toxicity. Medicines may include:
• Steroids such as prednisone
• Cyclosporine
• Voclosporin
• Tacrolimus
• Cyclophosphamide
• Azathioprine
• Mycophenolate
• Rituximab
• Belimumab
Ongoing clinical trials continue to explore new treatments for lupus nephritis.
Treatment options for kidney failure
For individuals who develop kidney failure, treatment options include:
• Dialysis, which filters the blood to remove waste and excess fluid, maintains mineral balance, and helps manage blood pressure
• Kidney transplant, replacing failed kidneys with a donor kidney to restore kidney function
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