Nephritis

Nephritis (nef-RY-tis) is an inflammation of one or both kidneys that can result in kidney damage.

Polly's Sore Throat

Polly will always remember fifth grade because she missed so much of it. She missed one week of school because she had strep throat, a sore throat caused by streptococcal bacteria. Several weeks later, Polly felt very tired, she lost her appetite, her abdomen and back hurt, and her face looked puffy. She rarely had to urinate, and when she did, her urine was dark like cola. Polly's doctor suspected that she had a case of acute (sudden) nephritis that was caused by her strep throat. He explained that her kidneys were not working properly and that waste products from the cells were building up inside her body. Polly's condition got worse. She spent several days in the hospital, then she recovered at home for several weeks.

What Is Nephritis?

The kidneys play an important role in filtering about 400 quarts of blood a day to remove cellular waste products and extra water. Each of the two bean-shaped kidneys is made up of about one million units called nephrons (NEF-rons). Each nephron consists of a collecting tubule that will eventually take wastes to the bladder, and a filtering unit called a glomerulus ^* .

In a person with nephritis, the glomeruli (plural of glomerulus) do not function properly, often as a result of a bacterial infection like Polly's. Not all the glomeruli are damaged to the same degree, however, so the kidneys can continue to function, but not as well as before. The kidneys may already be affected before the person notices symptoms.

Glomerulonephritis (Bright's disease)

There are several different types of nephritis. One of the most common is glomerulonephritis (glomer-u-lo-ne-FRY-tis), also called Bright's disease, a condition in which the glomeruli become inflamed and scarred. Common symptoms of this disease include tiredness, high blood pressure, and swelling of the hands, feet, ankles, and face. This swelling is called edema (e-DEE-ma). The person will pass blood and protein in the urine.

Acute nephritis

Another type of nephritis that commonly affects children occurs as a result of infection. Sometimes a bacterial infection can spread from another part of the body, such as the bladder, to the kidney. The body's disease-fighting proteins, or antibodies, can adhere to the glomeruli, causing them to become inflamed. This type of nephritis usually is acute, or sudden, and many affected children recover without long-term kidney damage.

Other causes

Nephritis can occur as a side effect of other diseases, such as diabetes ^* , and of autoimmune disorders such as systemic lupus erythematosus ^* . Nephritis also can be caused by the overuse of certain common drugs, such as ibuprofen (i-bu-PRO-fen) and acetaminophen (a-set-a-MIN-a-fen), and by sniffing glue or inhaling gasoline.

What Happens When People Have Nephritis?

Symptoms

Acute nephritis is characterized by fatigue, loss of appetite, abdominal and back pain, and edema. People with chronic nephritis might not show any outward symptoms. However, protein and red blood cells can usually be seen when a doctor examines their urine under a microscope. If left untreated, chronic nephritis may cause a drastic reduction in kidney function, and the patient's kidney tissue will deteriorate. The patient may develop high blood pressure and may die either from kidney or heart failure.

Treatment

To treat acute nephritis, the doctor may prescribe anti-biotics to treat infection, anti-inflammatory drugs to reduce symptoms of inflammation, and diuretics to reduce edema.

Chronic nephritis cannot be cured, but it can be treated. The goal of treatment is to slow the deterioration of the kidneys. Drugs may be used to treat high blood pressure and a special diet may be prescribed to relieve the load on the kidneys. People with an overactive immune system that triggers nephritis may be given immunosuppressant drugs to slow down the attack on the kidneys by the immune system.

Nephritis can lead to kidney failure, in which case dialysis or a kidney transplant is required. Dialysis is a procedure in which blood is passed through a machine to filter out waste products and extra water, then returned to the person's body. A kidney transplant is a procedure in which a diseased kidney is surgically replaced with a healthy kidney from a compatible donor.