What is Lupus Nephritis and Why Is It More Common in Blacks?

Systemic lupus erythematosus, or lupus, is a condition that can affect the skin, joints, and organ systems in the body. It occurs as a result of the body’s immune system, which usually protects the body from disease, attacking its own tissues, cells, and organs including the kidneys.¹ According to the Lupus Foundation of America, about 1.5 million Americans are affected by lupus.

While lupus can affect individuals of all ages and ethnic backgrounds, minority groups including Blacks are impacted the most, and women are affected more than men.² Black women are most impacted by this condition.³ Up to 60% of lupus patients will develop lupus nephritis.^1,5

What is Lupus Nephritis?

Definition

Lupus nephritis is a type of kidney disease caused by lupus. It is a common but serious lupus-related health complication, meaning only patients with lupus can develop lupus nephritis. It is caused by the body mistakenly attacking the kidneys, leading to swelling and scarring of the blood vessels that are responsible for filtering kidney waste.⁴ Men are more likely to develop lupus nephritis than women. Blacks, much like Asian Americans, Pacific Islanders, and Hispanics, remain at high risk for developing lupus nephritis.⁶

Lupus nephritis, if left untreated, may result in impaired kidney function or kidney failure requiring dialysis or a kidney transplant. It is also a risk factor for developing end stage renal disease. Severe forms of lupus nephritis may cause permanent kidney scarring. Patients with lupus nephritis are at a higher risk of developing certain types of cancer and heart problems.¹ There is no cure for this disease, but treatment can help manage symptoms and prevent disease progression.

Signs and Symptoms of Lupus Nephritis

Signs and symptoms of lupus nephritis may vary. Symptoms may not be noticeable at onset of the disease, and it may take up to 5 years after lupus symptoms appear to recognize symptoms of lupus nephritis.⁵ Potential symptoms should always be evaluated by a healthcare professional to confirm or rule out a diagnosis of lupus nephritis. The most common symptoms include^1,4-6:

• Weight gain
• Swelling (usually in the legs, feet, or ankles)
• Urine changes
  • Frequent urination
  • Blood or protein in urine (may only be visible under a microscope)
• High levels of waste (creatinine) in your blood
• High blood pressure

Lupus Nephritis in Blacks

Why are lupus and lupus nephritis more common in Blacks? We don’t know. Some experts believe it may be related to genetics, however there may also be hormonal and environmental causes.^3,6 Additional research is needed to help better understand and evaluate this condition.

Importance of Clinical Trial Participation

A surprising 63% of Americans surveyed had limited knowledge of lupus and its symptoms or had never heard of the condition. This proves there is still much work to be done in raising awareness and knowledge surrounding lupus and its complications.²

Clinical trials allow researchers to contribute to improving quality of care and identifying and exploring better treatment options. Clinical trials for lupus have not had much success recruiting minority patients to participate. Unfortunately, Black patients are underrepresented in clinical trials due to a number of barriers such as limited knowledge of clinical trials and when they occur, feelings of anxiety and lack of trust surrounding clinical trial participation, and limited education about the disease.⁷

Blacks make up around 12% of the United States population but are only represented in clinical trials at a low rate of 5%.⁷ In order to gain more insight and reduce health disparities, it is important to increase participation of Black patients in lupus-related clinical trials. If you have been diagnosed with lupus nephritis (LN), you may be able to participate in an important new study and potentially avoid further damage to your kidneys. Learn more here.

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References:

1. NIH – Lupus and Kidney Disease (Lupus Nephritis)
2. Lupus Foundation of America – Lupus Facts and Statistics
3. CDC – Systemic Lupus Erythematosus (SLE)
4. National Kidney Foundation – Lupus and Kidney Disease (Lupus Nephritis)
5. Lupus Foundation of America – What is Lupus Nephritis?
6. American Kidney Fund – Lupus Nephritis: Symptoms, treatment, and complications
7. NIH – The State of Lupus Clinical Trials: Minority Participation Needed
8. National Kidney Foundation – Are Clinical Trials Safe?