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Secondary Illness/Vasculitis

Diseases of the Kidney Filters can occur as the body’s response to illness. A number of rare kidney problems together are the number 7 cause of kidney failure in the US (they cause about 2%).1 These include:

  • Lupus – This autoimmune disease can flare up and affect the skin, joints, blood, and kidneys. About 1 in 3 people with lupus will have a kidney problem that needs treatment. Foamy urine (with protein in it) and swelling are the main symptoms.2
  • Hemolytic uremic syndrome (HUS) – HUS is one of the most common causes of kidney failure in children. Most HUS is due to food poisoning with E coli, which causes bloody diarrhea. Kidney problems are acute (sudden), but can be long-term.3
  • Scleroderma – This disease causes too much collagen to be made, which makes skin, tissues or organs become stiff. It can affect the kidneys.4
  • Vasculitis – This group of diseases causes inflamed blood vessels, from very small vessels all the way up to arteries. It includes:
    • Wegener’s granulomatosis (WG) – WG inflames blood vessels so less blood reaches some organs, like the nose, sinuses, windpipe, lungs, and kidneys.5
    • Henoch-Shonlein purpura – This disease causes purple skin spots on the legs and inflamed blood vessels that can affect kidney function.6
    • Polyarteritis nodosa (PAN) – PAN is an autoimmune disease that causes blood vessels to swell. It can affect the skin, and many organs, including the kidneys.7

What You Can Do

In most cases, while you can’t prevent or treat these problems, you can help protect your kidneys if you:

  • Consider immune suppressant drugs for Lupus.8,9 These drugs include steroids and some cancer fighting drugs.
  • Have an ANCA blood test every 6 weeks to follow active Wegener’s. This test can be done less often when the disease is in remission.
  • Keep your blood pressure in control. Avoiding the “double-whammy” of high blood pressure and any other kidney problem can help protect your kidneys. Work with your doctor to find blood pressure drugs that will work for you. Ask about diet and exercise to help blood pressure.
  • Find a support group. You can get tips and stay on top of new research findings when you find others who have the same problem. Look in our Links section below for ideas.
  • Learn all you can about your condition. Knowledge is power, and new research is being done all the time.
  • Seek out a specialist. When you have a rare disease, you need to find a doctor who knows what you are up against and what the current research says. No doctor can stay up to date on every illness. Ask for a referral to an expert who can consult with your doctor, or find one by talking to others who have the disease.
  • Treat the symptoms. You may spill protein into your urine, lose too much water or salt, or have pain that raises your blood pressure. Getting treatment for these symptoms can help take some of the stress off of your kidneys.
  • Avoid known kidney toxins
  • Check kidney function once a year. A test for protein in your urine and the level of creatinine in your blood can help you and your doctor see how well you’re doing.

Questions to Ask Your Doctor About Protecting Your Kidneys from Your Other Illness

  1. How do you plan to track my kidney health, and how often should I get tested?
  2. Can you refer me to an expert in this disease who can work with you to help protect my kidneys and my health?
  3. Will immune suppressing drugs be helpful in my case?
  4. Will certain blood pressure drugs (like ACE inhibitors) protect my kidneys?
  5. What treatments are available to help my symptoms?

Links to Learn More

1 USRDS 2006 ADR, table A.7 2 http://www.nlm.nih.gov/medlineplus/ency/article/000481.htm 3 http://kidney.niddk.nih.gov/kudiseases/pubs/childkidneydiseases/hemolytic_uremic_syndrome/ 4 http://www.scleroderma.org/medical/overview.shtm 5 http://www3.niaid.nih.gov/healthscience/healthtopics/wegener/default.htm 6 http://www.nlm.nih.gov/medlineplus/ency/article/000425.htm 7 http://www.nlm.nih.gov/medlineplus/ency/article/001438.htm 8Chan TM. Preventing renal failure in patients with severe lupus nephritis. Kidney Int . Apr;(94):S116-9. 9Fianc RS, Roberts MA, Strippoli GF, Chadban SJ, Kerr PG, Atkins RC. Treatment for lupus nephritis. Cochrane Database Syst Rev. 2004;(1):CD002922

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