Lupus Nephritis | Vital Diagnostic Tests for Diagnosis and Treatment
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In this program:
What diagnostic testing is used for lupus nephritis diagnosis and treatment? Medical laboratory scientist Dr. Kyle Riding explains key tests that help rule out other conditions, what is examined in the tests, and when a kidney biopsy is needed.
Transcript
Deandre White:
So what lab tests are performed in the evaluation of lupus nephritis, and what diagnostic considerations for lupus nephritis should be taken into consideration?
Dr. Kyle Riding:
That's a great question. One of the...you hear a term like "lupus nephritis" and you think it's going to be some really fancy lab test that's going to examine for this. But actually the first thing your provider's going to do is say, "Hey, let's perform a urinalysis. Here, here's the cup. Go give me a urine sample." Because that lupus nephritis, the damage that's happening to the kidneys, the damage is going to cause very specific cellular elements to show up in the urine. Red cells will be there, white blood cells will be there, because those filters in your kidney are not working right, and things are making it through that shouldn't. So that's one of the first early warning signs.
Another is a simple chemistry test, a "routine" I should say. It's not simple but a routine chemistry test. The eGFR, that estimated glomerular filtration rate will go down in patients with lupus nephritis. So if you see a patient with lupus and the eGFR is reducing at a faster than expected rate, this is of concern. And depending on the kind of findings that are there, the physician may want to move forward and do a kidney biopsy, where they take a piece of your kidney out and they look at it under the microscope to look for that inflammation in those nephrons. And so that is technically the definitive test, but your physician may want to do those easier screening tests before they stick a needle into you and take out a piece of your kidney. So definitely follow through with that.
Deandre White:
So at what point would a kidney biopsy be considered? "Yes, we really need to do this?"
Dr. Kyle Riding:
So I would say, when there is a urinalysis where there's red blood cells or white blood cells present in the urine, there's no evidence of a urinary tract infection, by the way. So if a UTI has been ruled out, patient has lupus, there's red cells and white cells in the urine, and we're seeing a reduction in the glomerular filtration rate, a renal biopsy would definitely be indicated at that point.
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