Tag Archives: Glomerulonephritis

Nephritis

Definition:
Nephritis is inflammationof the nephrons 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 affect the kidneys’ function, including their ability to filter waste and this can be caused by many different conditions.

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Symptoms may develop as the disease gets worse, but as nephritis resolves completely in about 60 per cent of adults and as many as 90 per cent of children, for many it comes and goes with little disruption to their life.

The downside is that for those in whom the disease doesn’t get better and instead progresses into a more severe condition, advanced kidney (renal) failure may have developed before they have had any reason to seek medical help.

Types:
*Glomerulonephritis is inflammation of the glomeruli. (When the term “nephritis” is used without qualification, this is often the condition meant.)...CLICK & SEE

*Interstitial nephritis or tubulo-interstitial nephritis is inflammation of the spaces between renal tubules……CLICK & SEE

*Pyelonephritis is inflammation that results from a urinary tract infection that reaches the pyelum (pelvis) of the kidney…….CLICK & SEE

*Lupus nephritis is an inflammation of the kidney caused by systemic lupus erythematosus (SLE), a disease of the immune system....CLICK & SEE

Symptoms:
Symptoms of nephritis include:

•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

About half of those who develop acute nephritis actually have no symptoms. If symptoms do develop, they point clearly to the problem. The inflammation causes blood and protein to leak into the urine. As protein levels in the blood fall, excess fluid accumulates in the body.

Tests show protein, blood cells, and kidney cells in the urine, while a high concentration of the body’s waste products of metabolism (such as urea and creatinine) may be found in the blood.

Swabs of the throat may show there’s been a streptococcal infection, while blood tests may be used to check for antibodies to streptococci or other infections, or signs of an abnormal immune response.

Sometimes a small biopsy or sample of tissue is taken from the kidney to examine in the laboratory.

Causes:
The causes of nephritis (or acute nephritic syndrome as the collection of symptoms is sometimes called) tend to be different in adults and children.

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. This condition is called post-streptococcal glomerulonephritis.

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).

Risk Factors:
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.

Diagnosis:
Your doctor may suspect lupus nephritis if your urine is bloody or has a foamy appearance, if you have high blood pressure, or if you show signs of swelling in your hands or feet. Diagnostic tests for lupus nephritis  may include:

*Renal function testing.  Nephrologists may use a variety of tests, including blood tests and 24-hour urine collection, to accurately measure your kidney function. Iothalamate clearance testing, which uses a special contrast agent to track how well your kidneys are filtering, may be done if traditional tests don’t provide clear measurement of your kidney function.

*Kidney biopsy. Biopsy is the gold-standard test to confirm the diagnosis of many kidney diseases, including lupus nephritis. It can also help determine the severity of the disease. Because of the large number of people treated for kidney diseases.

Treatment :
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.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://en.wikipedia.org/wiki/Nephritis
http://www.bbc.co.uk/health/physical_health/conditions/nephritis1.shtml
http://www.mayoclinic.org/lupus-nephritis/diagnosis.html
http://commons.wikimedia.org/wiki/File:Diffuse_proliferative_lupus_nephritis.jpg

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Glomerulonephritis

Alternative Names: Glomerulonephritis – chronic; Chronic nephritis; Glomerular disease; Necrotizing glomerulonephritis; Glomerulonephritis – crescentic; Crescentic glomerulonephritis; Rapidly progressive glomerulonephritis

Definition:
Glomerulonephritis is a type of kidney disease in which the part of your kidneys that helps filter waste and fluids from the blood is damaged.

It is an inflammation of the tiny filters in your kidneys (glomeruli). Glomeruli remove excess fluid, electrolytes and waste from your bloodstream and pass them into your urine.


You may click to see the picture

The inflammation can be caused by many different conditions. but is usually due to an overactivity of the immune system.

Glomerulonephritis can be acute — a sudden attack of inflammation — or chronic — coming on gradually.

If glomerulonephritis occurs on its own, it’s known as primary glomerulonephritis. If another disease, such as lupus or diabetes, is the cause, it’s called secondary glomerulonephritis. If severe or prolonged, the inflammation associated with glomerulonephritis can damage your kidneys. Treatment depends on the type of glomerulonephritis you have.

Symptoms:
There are seven different types of glomerulonephritis, that present in very different ways. For some types, symptoms can include ankle swelling that develops over months or years. For others, shortness-of-breath over days or weeks (due to water in the lungs) causing a rapid onset of kidney failure.

The outlook is also variable, from complete recovery with no treatment, to end-stage renal failure (ESRF), requiring dialysis and/or a transplant. Some types of glomerulonephritis can return in a transplant.

The various symptoms of the different types also include:
*Swelling of the face, eyes and legs
*Reduction in urine volume
*Dark urine (containing blood which may not be visible)
*Headaches and visual disturbances
*Drowsiness
*Tiredness and general malaise (feeling ill)
*Nausea
*Loss of appetite
*Rashes and itchy skin
*Pink or cola-colored urine from red blood cells in your urine (hematuria)
*Foamy urine due to excess protein (proteinuria)
*High blood pressure (hypertension)
*Fluid retention (edema) with swelling evident in your face, hands, feet and abdomen
*Fatigue from anemia or kidney failure

Tests for the condition show protein, blood cells, and kidney cells in the urine, while a high concentration of the body’s waste products (such as urea and creatinine) may be found in the blood.

Swabs of the throat may show there’s been a streptococcal infection, while blood tests may be used to check for antibodies to streptococci or other infections, or signs of an abnormal immune response.

All patients will need a kidney biopsy (removal of a piece of kidney with a needle) to make a definite diagnosis.

Sometimes when there are no symptoms, the problem is picked up by a routine blood test, or during investigation of high blood pressure

Causes:
Primary causes are ones which are intrinsic to the kidney, whilst secondary causes are associated with certain infections (bacterial, viral or parasitic pathogens), drugs, systemic disorders (SLE, vasculitis) or diabetes.

Glomerulonephritis may be caused by specific problems with the body’s immune system. Often, the precise cause of glomerulonephritis is unknown.

Damage to the glomeruli causes blood and protein to be lost in the urine.

The condition may develop quickly, with loss of kidney function occurring over weeks and months (called rapidly progressive glomerulonephritis).

In about a quarter of people with chronic glomerulonephritis there is no history of kidney disease and the disorder first appears as chronic renal failure.

Risk Factors:
The following increase your risk of developing this condition:
•History of cancer
•Blood or lymphatic system disorders
•Exposure to hydrocarbon solvents
•Infections such as strep infections, viruses, heart infections,or abscesses
•Diabetes
Many conditions are known to cause or increase the risk for glomerulonephritis, including:
•Focal segmental glomerulosclerosis
•Goodpasture syndrome
•Membranoproliferative GN
•IgA nephropathy
•Lupus nephritis or Henoch-Schonlein purpura
•Anti-glomerular basement membrane antibody disease
•Blood vessel diseases such as vasculitis or polyarteritis
•Amyloidosis

In most cases, no cause is found. Though in a few patients, they may be ‘set off’ by an infection or a cancer. Post-streptococcal glomerulonephritis is now extremely rare

There is also a very serious type called ’rapidly progressive glomerulonephritis’ (RPGN), which can follow a flu-like illness in the month before symptoms start in 50 per cent of patients. This can cause kidney failure in days or weeks and can be linked to bleeding from the lungs, causing blood to be coughed up.

Diagnosis:
Specific signs and symptoms may suggest glomerulonephritis, but the condition often comes to light when a routine urinalysis is abnormal. Because symptoms develop gradually, the disorder may be discovered when there is an abnormal urinalysis during a routine physical or examination for unrelated disorders.

Glomerulonephritis can cause high blood pressure. It may only be discovered as a cause of high blood pressure that is difficult to control.

Laboratory tests may reveal anemia or show signs of reduced kidney functioning. A kidney biopsy confirms the diagnosis.

Later, signs of chronic kidney failure may be seen, including swelling (edema), polyneuropathy, and signs of fluid overload, including abnormal heart and lung sounds.

Imaging tests that may be done include:
•Abdominal CT scan
•Abdominal ultrasound
•Chest x-ray
•IVP

Urinalysis and other urine tests include:
•Examination of the urine under a microscope
•Creatinine clearance
•Total protein
•Uric acid, urine
•Urine concentration test
•Urine creatinine
•Urine protein
•Urine RBC
•Urine specific gravity

This disease may also affect the results of the following blood tests:
•Albumin
•Anti-glomerular basement membrane antibody test
•Anti-neutrophil cytoplasmic antibodies (ANCAs)
•BUN and creatinine
•Complement component 3
•Complement levels

Treatment:
Treatment varies depending on the cause of the disorder, and the type and severity of symptoms. High blood pressure may be difficult to control, and it is generally the most important aspect of treatment.

Medicines that may be prescribed include:
•Blood pressure medications are often needed to control high blood pressure. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are most commonly prescribed.
•Corticosteroids may relieve symptoms in some cases.
•Medications that suppress the immune system may also be prescribed, depending on the cause of the condition.

A procedure called plasmapheresis may be used for some cases of glomerulonephritis due to immune-related causes. The fluid part of the blood containing antibodies is removed and replaced with intravenous fluids or donated plasma (without antibodies). Removing antibodies may reduce inflammation in the kidney tissues.

Dietary restrictions on salt, fluids, protein, and other substances may be recommended.

Persons with this condition should be closely watched for signs that they are developing kidney failure. Dialysis or a kidney transplant may eventually be necessary.

Lifestyle and home remedies:-
Your doctor may recommend lifestyle changes, including:

*Restricting salt intake to prevent or minimize fluid retention, swelling and hypertension

*Cutting back on protein and potassium consumption to slow the buildup of wastes in your blood

*Maintaining a healthy weight

*Controlling your blood sugar level if you have diabetes

Possible Complications:
•Nephrotic syndrome
•Acute nephritic syndrome
•Chronic kidney failure
•End-stage kidney disease
•Hypertension
•Malignant hypertension
•Fluid overload — congestive heart failure, pulmonary edema
•Chronic or recurrent urinary tract infection
•Increased susceptibility to other infections
•Hyperkalemia

Prognosis:
Glomerulonephritis may be a temporary and reversible condition, or it may get worse. Progressive glomerulonephritis may lead to chronic kidney failure and end-stage kidney disease.

If you have nephrotic syndrome and it can be controlled, other symptoms may also be controlled. If it can’t be controlled, end-stage kidney disease may result.

Prevention:
There is no specific way to prevent most cases of glomerulonephritis. Some cases may be prevented by avoiding or limiting exposure to organic solvents, mercury, and nonsteroidal anti-inflammatory drugs (NSAIDs).

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/in_depth/kidneys/glomerulonephritis1.shtml
http://www.nlm.nih.gov/medlineplus/ency/article/000484.htm
http://www.mayoclinic.com/health/glomerulonephritis/DS00503
http://en.wikipedia.org/wiki/Glomerulonephritis

http://www.marvistavet.com/html/body_glomerulonephritis.html

http://www.butler.org/body.cfm?id=125&chunkiid=96731

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