Lupus is a disease that can have many different symptoms, varying from extreme fatigue to joint pain and inflammation, and those symptoms can greatly vary depending on the stage of the condition. "People can have mild or more aggressive symptoms and stages of lupus," Dr. Alana Levine, a rheumatologist in New York City told Billboard. "One of the organs that lupus can affect is the kidneys. It's called lupus nephritis when that happens, which is inflammation of the kidneys." When the kidneys are inflamed, Dr. Levine explained, they're unable to properly filter toxins from the body out through the urine. "As toxins build up, the kidneys might not be able to filter the blood properly, and in severe cases, a patient can become very sick," even going into complete kidney failure if not treated.
What is Lupus? A Primer on Selena Gomez's Condition
"A lot of times, you'll see a slow development of somebody's kidneys not working well," Levine said, who sees her patients every 3 months to do blood work and urine tests, checking to see if blood cells or protein is accumulating in the urine. "If there is accumulation, that's a warning sign. So as a rheumatologist, I'll work with a nephrologist (kidney doctor) to do a kidney biopsy and see if someone has lupus nephritis."
If the patient does have lupus nephritis, the general practice is to give the patient medication and see if they respond. If the patient isn't responding to the medication, that is when the patient's team of doctors will begin discussing the option of a kidney transplant. In Gomez's case, the best option was probably to get a kidney transplant to treat her lupus nephritis and luckily was able to have her friend Francia Raisa donate a kidney. "Donors need to go through rigorous screening before their kidney can be approved," Levine said. "Cancer screenings, infection screenings, multiple blood tests." But once the kidney transplant is approved and the surgery deemed successful, there's very little chance of the kidney becoming infected again.
"Post surgery, every person who gets a kidney transplant will be on medicines daily that suppress the immune system so the body won’t reject the new kidney and think it’s a foreign object," Levine said. "It just so happens that many of those immune suppressants are also used to treat lupus. So when a patient who had lupus nephritis is on immune suppressants, their other lupus symptoms are being treated as well."