Lupus Nephritis Might Not Increase Infection Risk

Those with lupus have an increased risk of infection and an increased risk of developing a condition called lupus nephritis. Researchers have been working hard to determine if there is an underlying link between all of these issues.

What is lupus nephritis?

Lupus nephritis is a type of kidney disease. As its name implies, it is associated with lupus. Lupus can attack many areas of the body and cause damage and inflammation. The kidney is made of tiny structures called nephrons that are involved in filtering waste products out of the blood and making urine. When these nephrons get inflamed, it is called nephritis.

Some estimates have suggested that over 50 percent of people with lupus will develop lupus nephritis. At least 10 percent of these people will eventually develop end-stage renal disease. Common symptoms of lupus nephritis include:1,2

  • Darkened urine
  • High blood pressure
  • Swelling or puffiness of the face, arms, or legs (including the hands and feet)

Although lupus nephritis cannot be cured, it can be managed with medicines that suppress the immune system.1,2

The connection between lupus and infection risk

People with lupus have a greater chance of developing infections than those without the condition. This may be due to multiple causes.

Lupus itself can weaken the immune system and a person’s overall function, increasing the risk of infection. Additionally, many of the medicines used to manage lupus further suppress the immune system and raise the risk of getting sick from another cause. Some of the most common infections people with lupus experience are respiratory tract infections, skin infections, and urinary tract infections.3

Treatments for these infections are determined based on their underlying cause. For example, fungal infections are treated with antifungal medicines, viruses are treated with antivirals, and so on.

However, people with lupus can reduce their risk of getting sick in some of the same ways people without lupus can reduce their risk, including:

  • Regular hand washing
  • Avoiding others when they are sick
  • Staying up-to-date on vaccinations
  • Seeking medical attention as soon as necessary

Latest lupus research

A study published in the journal Lupus Science & Medicine wanted to learn more about the relationship between lupus nephritis and infection risk. Past research suggested that there may be an increased risk of an infection specifically in those with lupus nephritis. However, there is not a clear answer on the topic. While there is still more research needed, the latest study suggests that lupus nephritis may not be related to an increase in infection risk.4

In the study, the researchers compared past medical records from over 80 people with lupus nephritis to more than 80 similar people who had lupus, but not lupus nephritis. The people studied and their medical records came from Queensland, Australia. Only about 9 percent of those with lupus nephritis experienced a serious infection during the studied time period (about 7 years, between 2009 and 2016) compared to 6 percent with lupus only. These results suggest that the rate of serious infection is similar among those with lupus regardless of lupus nephritis status.

The researchers also found that lupus nephritis was not related to longer hospital stays, hospital admissions, or mortality rates. However, they did find that infection risk may be related to baseline immunosuppressant therapy for lupus nephritis. Basically, those on higher doses of these drugs used to treat lupus and lupus nephritis may be at a higher risk of infection due to their lowered immune response. Additionally, those with other medical conditions alongside their lupus and lupus nephritis were also at a higher risk of developing serious infections.4

What does this all mean?

Overall, this study is encouraging for some, as it suggests that there may not be an increased risk of infection simply related to having lupus nephritis. However, those on high-dose immunosuppressant drugs or with other co-occurring conditions may still be at higher risk.

More research is needed to further understand this relationship. In the meantime, good infection prevention through hand washing, vaccinations, avoiding sick contacts, and other methods are a great way to reduce risk regardless of your underlying health status.

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