darkwater

Yep. Membranous glomularnephritis (sp?). When did it start? Who knows? The doctors certainly don't, and I don't have a clue. First outward lupus symptoms date to October of 2003, so maybe then. But I suspect I have had this for around a decade. Totally silent. I actually thought they must be kidding to say my kidneys were damaged. No pain, no discomfort, no urinary symptoms, no nothing. If your doctor recommends it, do the biopsy. These things scare people, scared me half to death, but the cold hard fact is that if lab tests show something significant going on with your kidneys, this is the only way to get concrete information on the state of what has happened to them and it will help to know how you should be treated to prevent or at least slow future deterioration.

Sorry if I repeat something you have already told us about your treatment. Initially, you will likely be offered prednisone, which will work on all those wbc, casts, and other stuff you have going on in your urine. That is, unless your labs are way off the chart or you are having severe symptoms in other parts of your body, in which case they may recommend going ahead with the chemotherapy drugs from the start. In the short term, prednisone is relatively harmless, so if you are lucky, a good dose tapered off over a few weeks or even months may jolt the kidneys into remission. I have read accounts of this, so it does happen. If the first round of steriods don't do the trick, then they will probably want a combination of a low maintenance dosage of prednisone along with one of the chemo drugs or just a chemo drug alone.

I truly wish you the best as you make these choices. God bless.