Nephritis (nef-RY-tis) is an inflammation of one or both kidneys that can result in kidney damage.
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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 * .
* glomerulus (glom-ER-you-lus) is from a Greek word meaning "filter." The glomerulus is a knot of blood vessels that have the job of filtering the blood.
175 Years Ago:
Richard Bright, a British physician who lived from 1789 to 1858, was the first to describe the kidney disorder known today as Bright's disease, or nephritis. Bright studied kidney function and was meticulous in his clinical observations. He worked with kidney patients, studying their symptoms, and then he correlated symptoms with the kidney defects he observed during autopsies (examinations after death). The results of Bright's research first appeared in Reports of Medical Cases in 1827. Bright also contributed to the study of lung disease, heart disease, various fevers, and tumors.
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.
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.
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?
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.
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.
* diabetes (di-a-BEE-teez) is an impaired ability to break down carbohydrates, proteins, and fats because the body does not produce enough insulin or cannot use the insulin it makes.
* systemic lupus erythematosus (sis-TEM-ik LOO-pus er-i-them-a-TO-sus), sometimes just called lupus, is a chronic inflammatory disease that can affect the skin, joints, kidneys, nervous system, membranes lining body cavities, and other organs.
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.
Bock, Glenn H. A Parent's Guide to Kidney Disorders. Minneapolis: University of Minnesota Press, 1993.
U.S. National Kidney and Urologic Disease Information Clearinghouse, 3
Information Way, Bethesda, MD 20892-3580. This division of the National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) posts
fact sheets about hematuria, pyelonephritis, and lupus nephritis at its