Nephritis

Nephritis

Nephritis is inflammation of one or both of the kidneys – the organs that filter the blood and get rid of excess fluid and unwanted chemicals. The inflammation can be caused by many different conditions.

Nephritis is inflammation of one or both of the kidneys – the organs that filter the blood and get rid of excess fluid and unwanted chemicals. The inflammation can be caused by many different conditions.

Symptoms
• Swelling of the tissues (initially the face and around the eyes, later more prominent in the legs)
• Reduction in urine volume
• Dark urine (contains blood which may not be visible)
• Increase in blood pressure
• Headaches
• Drowsiness
• Visual disturbances
• Tiredness and general malaise (feeling ill)
• Nausea
• In rapidly progressive disease, loss of appetite, vomiting, abdominal pain and joint pain may occur
• Chronic nephritis may go unnoticed for years until symptoms of kidney failure appear: tiredness, itchy skin, nausea and vomiting, shortness of breath

Causes
• One of the commonest, especially in children, is after infection with the streptococcus bacteria, which leads to an immune reaction that damages the filtering units of the kidney known as the glomeruli. Other causes seen more frequently in children than adults include Henoch-Schönlein purpura (an inflammation of the blood vessels caused by an abnormal immune response) and haemolytic-uraemic syndrome (an abnormal immune reaction with triggers including gastrointestinal infection).
• In adults, diseases that frequently underlie nephritis include vasculitis (inflammation of the blood vessels), pneumonia, abscesses, infections such as measles, mumps or glandular fever, hepatitis, and a range of different immune disorders that cause types of glomerulonephritis.
• In more serious, rapidly progressive glomerulonephritis, about half of people remember having had a flu-like illness in the month before symptoms start.
• The treatment of nephritis depends on the type and cause of the condition. The aim is to reduce inflammation, limit the damage to the kidneys and support the body until kidney function is back to normal.
• Restriction of sodium (salt), potassium, protein and fluids in the diet may be necessary. Sometimes bed rest is advised. Steroids, or more powerful immunosuppressant drugs, may be given to reduce the inflammation.
• Antibiotics may be needed too, although in many cases the infection that initially triggered the nephritis has long since gone. Medication may also be needed to control blood pressure.
• In severe cases, renal dialysis may be necessary, although this may only be a temporary measure.
• Adults are slower to recover than children and more likely to develop complications or progress into chronic nephritis. Acute nephritic syndrome is unlikely to recur, but if it does there’s at least a one in three chance that an adult will develop what is known as ‘end-stage kidney disease’, leaving them in need of permanent dialysis or a kidney transplant.

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