Nephritis is the general term used to describe inflammation of the glomerulus, tubules or interstitial tissue in the kidneys. The condition affects functioning of the kidney and its ability to filter blood and excrete waste products via the urine.
Nephritis can be classified as acute or chronic, according to the rate of development. For example, acute nephritis progresses rapidly after a certain event, such as a throat or skin infection, and the underlying cause should be treated as soon as possible, usually with antibiotics. Chronis nephritis, on the other hand, gradually develops and may eventually result in kidney failure.
In many cases, the cause of nephritis is not precisely known. Some patients may have a family history of nephritis, which suggests a genetic link involved in causing the condition.
Nephritis may sometimes be caused by the response of the immune system to a stimulus. For example, the entry of a drug, poison or infection into the body can cause an immune response and stimulate the production of antibodies to protect the body. However, some of these antibodies may have the ability to cause damage to the kidneys, leading to inflammation and scarring of the glomerular filters in the kidneys.
The characteristic symptoms of nephritis are:
- Hematuria (blood in urine may lead to discoloration of the urine)
- Proteinuria or albuminuria (protein in urine may lead to frothy urine)
- Edema (swelling of the face, hands, feet and legs)
- Compromised kidney function
It is also common for patients with nephritis to feel fatigued, usually due to interruption in sleep when they need to go to the toilet during the night.
The severity of symptoms can vary significantly from a mild condition to a serious disease that causes kidney failure.
Due to the non-specific cases, nephritis can often be diagnosed late in the course of disease, after it has already caused damage to the kidneys. In fact, it is often detected in routine health checks rather than from patient-reported symptoms. Tests that are useful in the diagnosis of nephritis include:
- Dipstick test
- Estimated glomerular filtration rate
- Blood pressure test
In some cases, further testing may be required to determine the root cause of the inflammation. This may include ultrasound, computed tomography (CT) scans, magnetic resonance imaging (MRI) or a kidney biopsy.
The appropriate treatment for nephritis will depend on the type and cause of the condition. In many cases, specific therapy is not needed and observation to assess for signs of worsening symptoms is the only action.
needed. However, other patients may require medical treatment to manage associated infections, high blood pressure and specific symptoms such as edema.
Common treatments that may be used in the treatment plan for patients with nephritis are:
- Antibiotics to treat an infection causing acute nephritis
- Diuretics to relieve symptoms of edema
- Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) to manage hypertension
- Low-sodium diet to reduce symptoms of edema
It is important for follow-up appointments to be made regularly for patients with nephritis to assess changes and make treatment decisions to improve patient outcomes when indicated.
Reviewed by Afsaneh Khetrapal BSc (Hons)