Seeing Selena Gomez lying on a hospital bed awaiting a kidney transplant was shocking. This vibrant singer who graces our ears and our screens laid low? Why was she ill? What was the story behind the image?
Why did Selena Gomez need a kidney transplant? Selena Gomez has Lupus Nephritis which affects and can eventually damage the kidneys beyond repair and so she needed a kidney transplant to replace her damaged kidneys with a healthy one.
What is Lupus Nephritis?
Lupus Nephritis is a type of kidney disease. A person with Lupus (SLE) suffers from increased levels of inflammation and that can affect the organs so if someone has Lupus Nephritis they have SLE with organ involvement, in this case, the kidneys.
Selena Gomez has SLE with kidney involvement. Basically in Lupus, the immune system goes into overdrive and starts attacking healthy cells and in her case, it attacked her kidneys. Selena’s best friend stepped in and donated one of her kidneys. What an amazing gift! Selena will need to take immunosuppressants for the rest of her life to help stop her body from rejecting the kidney. These drugs are also useful in treating lupus since they literally suppress the immune system, but of course, they can leave you vulnerable to infection.
I personally have mild lupus, which my specialist noted , ‘doesn’t mean it’s not painful and difficult to live with but means you have no organ involvement’ Long may it last!! It is hard enough dealing with the pain and fatigue etc, but I can imagine how frightening dealing with such a life-threatening condition is!
What are the symptoms of Lupus Nephritis?
So what were Selena’s symptoms likely to have been? Initially, she may not have had symptoms but at every rheumatology appointment, a urine sample would be tested for protein and blood this is an early indication of problems with the kidneys. If there is a lot of protein in the urine it can become foamy.
High blood pressure is another indication and blood pressure is usually checked regularly.
Swelling in hands ankles and feet is another indicator. This oedema shows that the kidneys aren’t filtering out waste products effectively.
Bloods may show a high level of a waste product called creatine.
What are the stages of Lupus Nephritis?
The World Health Organisation used a classification system for Lupus Nephritis in 1964 which was then reviewed and updated by the International Society of Nephrology and the Renal Pathology Society. This table is taken directly from the WHO classification page as per the link.
Table 4. Abbreviated International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification of lupus nephritis (2003)
|a Indicate the proportion of glomeruli with active and with sclerotic lesions.|
|b Indicate the proportion of glomeruli with fibrinoid necrosis and cellular crescents.|
|c Class V may occur in combination with class III or IV in which case both will be diagnosed.|
|Indicate and grade (mild, moderate, severe) tubular atrophy, interstitial inflammation and fibrosis, severity of arteriosclerosis or other vascular lesions.|
|Class I||Minimal mesangial lupus nephritis|
|Class II||Mesangial proliferative lupus nephritis|
|Class III||Focal lupus nephritisa|
|Class IV||Diffuse segmental (IV-S) or global (IV-G) lupus nephritisb|
|Class V||Membranous lupus nephritisc|
|Class VI||Advanced sclerosing lupus nephritis|
Doctors will use blood and urine tests, if these show possible kidney involvement then they may perform a kidney biopsy which is the most reliable way to diagnose Lupus Nephritis and also how much damage has been done.
Can Lupus Nephritis be cured?
There is no cure for Lupus Nephritis but there are treatments to slow down and manage it and even, to put it into remission. The aim will be to avoid having to start dialysis and an eventual need for a kidney transplant.
How is Lupus Nephritis treated?
Lupus Nephritis is treated in a few ways,
- Diet, patients could be coached to limit the amount of salt and protein in their diets.
- Blood pressure medications also help stop protein leaking into the urine as well as addressing the high blood pressure problem.
- Diuretics can help with oedema.
These entry level interventions are not effective on their own for Lupus Nephritis. The next line of attack or defense… is Immune Suppressants these could be;
- Steroids, such as prednisone
- Azathioprine (Imuran)
- Mycophenolate (CellCept)
- Rituximab (Rituxan)
Immune suppressants stop the immune system from attacking healthy cells.
If these steps don’t stop the progression to kidney failure then dialysis will be needed and a kidney transplant.
Obviously Selena Gomez required a new kidney which was provided by her long term friend Francia Raisa. She appears to be healthy and well now, which is wonderful!
I cannot imagine truly, how hard it must be to keep fighting, keep positive, and have to go through something as hectic as a kidney transplant! It must be all emotions of hope, fear, desperation, highs, and lows. Feeling indebted to your donor perhaps? I salute you all who go through so much with this challenge that is Lupus.
Keeping pushing forward, keep trying new things, keep trying to minimise its hold n you. Most of all keep finding ways to be ‘you’ and not just ‘lupus’.
Please, as always, remember I’m not a doctor and you should always address your concerns and thoughts on treatments, etc to your doctor.