Lupus nephritis is a serious complication of lupus  — and because it doesn’t always cause symptoms right away, it’s important to find it early. Talk to your lupus doctor about getting screened (tested) for lupus nephritis.

About lupus nephritis

Lupus nephritis is a kidney disease caused by lupus. Studies show that as many as 3 out of every 5 people with lupus will develop lupus nephritis — including over half of children with lupus. 
With lupus nephritis, inflammation from lupus damages the kidneys  and stops them from working as well. That means that they don’t filter waste and extra water out of the body the way they should.

In the early stages of lupus nephritis, you might not notice any symptoms. But if the kidneys are damaged too much, they can fail — meaning they stop working altogether. 

If you have lupus, it’s important to get screened regularly for lupus nephritis. Finding lupus nephritis when it’s in the early stages means that you can start treatment right away — and limit the amount of damage to your kidneys.

Talk to your doctor about screening

The first step to getting screened for lupus nephritis is talking with your doctor about how often to be tested. 

According to the 2024 guidelines from the American College of Rheumatology (ACR) , people with lupus who don’t have known kidney disease should be screened for lupus nephritis: 

• At least once every 6 to 12 months
• Whenever they’re experiencing a lupus flare (periods when lupus symptoms get worse) — which could be more often than every 6 to 12 months 

The test to check for lupus nephritis is simple. Your doctor will check a small sample of your urine for extra proteins, which is a sign that your kidneys aren’t working as well as they should.

In some cases, if a urine test finds extra proteins, you may need a follow-up test called a kidney biopsy. For this test, your doctor takes a very small sample of your kidney tissue. Then, the tissue is looked at under a microscope to check for signs of damage.

If you have lupus, talk with your doctor about getting on a regular screening schedule to check for lupus nephritis. And be sure to let your doctor know right away if you’re experiencing a lupus flare. 

Get treatment if you have lupus nephritis 

If your screening tests show that you have lupus nephritis, your doctor will want to start treatment right away. 

Treatment for lupus nephritis  aims to lower inflammation and prevent further damage to your kidneys. Doctors use different categories, called classes, to describe how severe lupus nephritis is. Your treatment plan will depend on your lupus nephritis class and your overall health. 

Treatment for lupus nephritis usually involves taking medicines to prevent inflammation and protect your kidneys. Your doctor might also talk to you about other ways you can support kidney health, like by lowering high blood pressure, lowering high cholesterol, or keeping diabetes under control, if you have any of those conditions.

Monitor your kidney health

If you have lupus nephritis, it’s important to continue to get regular urine tests to monitor how well your kidneys are working — even if you’re being treated for lupus nephritis. 

According to the ACR guidelines, you’ll need to have a urine test every 3 to 6 months, depending on how well your symptoms are responding to treatment.