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Hi. Per one of my lupus hardcovers, lupus nephritis doesn't initially cause pain or discomfort; it's "silent" for a long time in terms of SYMPTOMS. However, kidney filtering problems DO show up, long before symptoms, in BLOOD LABS (low albumin, or elevated BUN & creatinine). When kidney function becomes poor enough to cause symptoms, those could include swelling, bloating, discomfort, shortness of breath, chest pain, fatigue, paleness, etc.

But there are causes besides lupus for blood in urine. And unlike lupus, these could cause fairly immediate kidney pain. As you said, kidney or bladder infection, and kidney or bladder stones. Also, a variety of other kidney conditions.

You should get copies of your recent labs (basic CBC etc. and whatever specialty labs have been run for lupus), urinalysis, and your upcoming kidney/bladder ultrasound. Do you know what's been found so far re lupus, like ANA and the more specific autoantibodies that are commonly seen in lupus? (Feel free to post on your labs. While we're not medical professionals, among us have had a lot of first-hand experience.)

I've had recurring kidney stones. Some, I probably passed without really noticing (smaller ones); I just felt a little off & didn't see visible blood in urine. Others caused a various symptoms, including dull lower back pain, sharp abdominal pain, urinary irritability & frequency, blood in urine, fever, chills, shakes, elevated leukocytes in urine, and elevated CRP and ESR in blood labs. My one total blockage made me wildly sick (nonstop vomiting). Tests typically run: blood labs, urinalysis, 24-hour urine collection, X-ray (but not all stone types actually show up on X-ray), and kidney/bladder ultrasound. Horribly, passing a stone can take 20-some days, depending on its size.

During my last bout, my GP prescribed an antibiotic, but when my urinalysis came back NOT showing a bacterial colony level consistent with an infection, she took me right off & sent me to a urologist. Do you know the results of your latest urinalysis, meaning why you were put on an antibiotic? Did it show bacteria? (That suggests infection but wouldn't rule out stones. Stones can actually cause infection.)

Just yell if this doesn't make enough sense. (I'm not sure I'm fully awake. Dog woke me up early... bad dog!) Hope you post more soon. Sending best wishes.

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