referred to Nephrology team and Haematuria Clinic after blood and proteinuria.

[KingArthur]

I am 76 years old and was diagnosed with Lupus nearly 3 years ago and then Psoriasis a year or so later. It has been a nightmare to get it under control - Acetretin did not do much, Cyclosporin worked well but affected my kidneys. They then tried Fumaderm and in fariness that did work. However, last visit and urine test showed blood in urine - this was repeated on 9th January and it showed blood again and protein. I have had a copy letter today saying I am being referred to a Nephrology Team and also to a Heamaturia Clinic and the Consultant is asking the Consultant Nephrologist if Fumaderm should be stopped!, Very very worried if this happens as my Psoriasis was very bad before I went on this. Also, am I right in thinking they suspect kidney disease? I also have low electrolytes and anaemia which can be linked. What sort of tests am I likely to have when I go to the Nephrology Team? Am I likely to be treated as an outpatient? Thanks for reading = just really want to know if anyone else has had these referrals and what happens.

[PMRpro]

Protein in urine is listed as a very rare side effect of Fumaderm. If there is blood found in urine then you will also find protein - blood contains proteins. Advanced renal disease is a contraindication for using Fumaderm so I imagine the doctor is making sure if it is OK to continue using it in the meantime while they check out the cause of the haematuria (blood in urine). Anaemia is very common in autoimmune disorders, not sure about the low electrolytes.

Try not to worry too much at the moment - cross bridges when you get to them. I know - it is easy for me to say!

I imagine they will want to do a cystoscopy - looking at the inside of the bladder to see of there is any obvious cause of the haematuria. That is usually done under a light GA if it is a rigid one, with local anaesthetic if a flexible one: this link has quite reassuring posts (I think at least):

patient.info/forums/discuss...

If that doesn't show much then maybe they will want to do a kidney scan - that is also usually done as an out-patient by the medical physics department in many hospitals, sometimes by radiology - it depends on the hospital. In some hospitals they keep you overnight - it all depends! You have a small amount of radioactive tracer injected and once it has got through the blood stream you lie still on a table while a special camera follows where it has gone. It can take quite a while depending on what they are looking for - but although you don't have to be totally immobile the entire time you do have to stay still so be sure you are comfortable to start with! There are other tests but they are usually only done if they find anything with the starting tests.

You will be given information about them all in advance - whether to take medication as normal, drinking, eating and getting home.

[LUPUSadmin]

Hi KingArthur,

Sorry to hear that you're having trouble with your health. A Nephrologist is a doctor who specialises in the kidney's so you're right to assume they have the kidney's in mind. We have a factsheet and a booklet available for download, both called 'LUPUS and the Kidneys' which might offer you some more information. These can be found here: lupusuk.org.uk/publications

These should give you a good idea of what to expect from tests and treatments.

Do you know when you'll be seeing the Nephrologist?

George

[KingArthur in reply to LUPUSadmin]

Thanks - no letter came through cc to GP with yesterdays date on it, so I would guess within a couple of weeks?. I am a little concerned though as I am on the highest dose of Fumaderm but the Dermo wants the Nephrologist to give opinion so I have to keep taking it until I hear back! I am taking 2 x 120mg 3x a day, although we are trying to get it down to 2 x 120mg 2 x a day plus 1 120mg.