Lupus Nephritis: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Lupus Nephritis?
A nephrologist, a kidney doctor, and a rheumatologist, a lupus doctor, usually treat lupus nephritis together. Your primary care doctor can help coordinate care. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is lupus nephritis?
Lupus nephritis is a type of kidney disease caused by systemic lupus erythematosus (SLE or lupus). Lupus is an autoimmune disease, which is a disorder in which the immune system attacks the body's own cells and organs. Kidney disease caused by lupus may get worse over time and lead to kidney failure.
Lupus can cause kidney damage that leads to changes in kidney function, including kidney failure. This is called lupus nephritis. If your kidneys fail, you will need dialysis or a kidney transplant to maintain your health.
Symptoms
The symptoms of lupus nephritis may include foamy urine. They may also include edema, which is swelling that occurs when your body has too much fluid, usually in the legs, feet, or ankles. You may also develop high blood pressure.
Kidney problems often start at the same time or shortly after lupus symptoms appear. They can include:
- Joint pain or swelling.
- Muscle pain.
- Fever with no known cause.
- A red rash, often on the face across the nose and cheeks, sometimes called a butterfly rash.
Causes and who gets it
Lupus nephritis is caused by lupus. Lupus is much more common in women than in men and most often strikes during the child-bearing years. Lupus is also more common in people of African or Asian background.
Kidney damage is one of the more common health problems caused by lupus. In adults who have lupus, as many as 5 out of 10 will have kidney disease. In children who have lupus, 8 of 10 will have kidney disease.
How doctors diagnose it
Lupus nephritis is diagnosed through urine and blood tests and a kidney biopsy.
A urine test looks for blood and protein in your urine. A high level of protein or a high number of red blood cells in the urine means kidney damage.
A blood test checks your kidney function by measuring creatinine, a waste product from the normal breakdown of muscles.
A kidney biopsy takes a small piece of kidney tissue to be looked at under a microscope. It can confirm a diagnosis of lupus nephritis, find out how far the disease has progressed, and guide treatment.
Treatment
Doctors treat lupus nephritis with medicines that suppress your immune system so it stops attacking and damaging your kidneys. The goals of treatment are to reduce inflammation in your kidneys and decrease immune system activity.
Your health care professional may prescribe a corticosteroid and a medicine to suppress your immune system. Lupus nephritis can cause high blood pressure in some people. You may need more than one kind of medicine to control your blood pressure.
ACE inhibitors and ARBs may help protect your kidneys, and diuretics help your kidneys remove fluid from your body.
Newer medicines are now available for some types of lupus, including lupus that affects the kidneys.
Treatment works well to control lupus nephritis, so you may not have complications. Between 10 to 30 percent of people who have lupus nephritis develop kidney failure.
If you have kidney disease, you may need to change what you eat. Follow your doctor's instructions about medicines and diet.
When to see a doctor
Early diagnosis and prompt treatment may help protect your kidneys. See a doctor if you have lupus and notice foamy urine, swelling in the legs, feet, or ankles, or high blood pressure.
Call 911 or go to the emergency room if you have severe trouble breathing, chest pain, fainting, or a seizure.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can check your blood pressure, order urine and blood tests, and coordinate care with your kidney and lupus specialists.
Common questions
Is lupus nephritis the same as lupus?
No. Lupus nephritis is a type of kidney disease caused by lupus.
Can lupus nephritis cause kidney failure?
Yes, it can. Between 10 to 30 percent of people who have lupus nephritis develop kidney failure.
How common is kidney disease in people with lupus?
Kidney damage is one of the more common health problems caused by lupus. In adults who have lupus, as many as 5 out of 10 will have kidney disease.
How is lupus nephritis diagnosed?
It is diagnosed through urine and blood tests and a kidney biopsy.
How is lupus nephritis treated?
It is treated with medicines that suppress your immune system so it stops attacking and damaging your kidneys.
Sources
- NIDDK - Lupus & Kidney Disease (Lupus Nephritis)
- NIAMS - Systemic Lupus Erythematosus (Lupus)
- MedlinePlus - Lupus
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
