Nephritis (Bright's Disease; Glome Ruloncphritis; Pyelonephritis)
Nephritis is the general term for acute or chronic inflammation or impairment of the kidneys caused by infection, a degenerative process, or vascular damage. The disorder is always serious because it can set the stage for kidney failure. Two of the most common forms of nephritis are:
Pyelonephritis, caused by an acute or chronic bacterial infection. High fever, chills, severe back pain, and an increased need to urinate, accompanied by burning pain, are typical symptoms.
Glomerulonephritis, which can be caused by a variety of disorders that damage the glomeruli, kidney structures that filter waste from the blood.
Children, for example, sometimes develop acute glomerulonephritis after a strep throat infection. Symptoms include headaches, blurred vision, generalized aches and pains, and fluid retention marked by facial puffiness in the morning, swollen ankles in the evening, arid decreased urination. The urine may be amber or rusty in color, because it contains blood and protein. Chronic glomerulonephritis develops slowly and without obvious symptoms until it reaches an advanced stage. It is sometimes secondary to diabetes or a disease such as lupus, which can damage the kidneys.
Diagnostic Studies and Procedures
The presence of blood and protein in the urine typically points to a kidney disorder. Other tests will be needed to look for the underlying cause, and may include blood studies and cultures, a 24-hour urine collection and analysis, X-rays, and such imaging procedures as a CT scan, ultrasound, and an intravenous pyelogram, in which a dye is injected into the kidneys before X-rays are taken. A kidney biopsy also may be ordered in some cases.
Medical Treatments
Bacterial pyelonephritis is treated with a combination of antibiotics, usually for several weeks, to prevent recurrence. Antibiotics are also prescribed for acute glomerulonephritis due to an infection. If necessary, kidney dialysis may be ordered temporarily until the kidneys have had a chance to recover. With chronic glomerulonephritis, diuretics may be necessary to remove any excess fluid from the body. Blood pressure should be regularly monitored; if it is too high, antihypertensive drugs will be prescribed.
Some studies have shown that the gradual development of glomerulonephritis caused by diabetes, one of the most common causes of chronic kidney failure in the United States, can be prevented by taking captopril (Capoten), which inhibits the angiotensin converting enzyme, a body chemical that helps to regulate blood pressure. When nephritis results in chronic kidney failure, long-term dialysis is necessary. Erythropoietin, a hormone that increases production of red blood cells, is given to counteract the anemia that commonly accompanies kidney failure. A kidney transplant is an alternative to dialysis for treating chronic kidney failure.
Alternative Therapies
Nephritis is a serious disorder that mandates careful medical treatment and monitoring. Before initiating any dietary change or other alternative therapy, be sure to check the procedure with your doctor.
Herbal Medicine. A few of the herbs that have a diuretic effect and thereby reduce the kidneys' workload are red clover, goldenrod, juniper berries, nettles, marshmallow root, and uva-ursi. These are taken as teas.
Nutrition Therapy. A clinical dietitian experienced in working with kidney patients can work out an appropriate diet. The goal is to limit the buildup of waste products and fluids in the blood. Generally, restriction of protein, phosphorus, sodium, potassium, and sometimes fluids is recommended. Calcium supplements may be needed, along with supplements of vitamins B6, folic acid, and C, if the diet does not supply the recommended dietary allowances (RDAs) of these essential nutrients. However, high doses of vitamin C can damage the kidneys further and should be avoided by anyone with reduced renal function.
Self-Treatment
Avoid nonprescription painkillers, especially acetaminophen and combination of aspirin and acetaminophen. These can worsen nephritis. Individuals with chronic kidney disease can benefit from participation in a self-help group where members can discuss stress management and their emotional problems.
Other Causes of Kidney Inflammation
In addition to infections, nephritis may be caused by drugs and numerous toxic substances, especially solvents, pesticides, and arsenic, lead, and other heavy metals. Glue sniffing or inhaling benzene and other toxic fumes also causes nephritis.