Nephritis
Types of nephritis
Definition
Etiology & pathogenesis
Methods of diagnostics
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Clinical picture
is inflammation of the kidneys and may involve the glomeruli, tubules, or interstitial tissue surrounding the glomeruli and
tubules
Glomerulonephritis (GN)
Pyelonephritis (PN)
Interstitial nephritis (IN)
GN is inflammation of renal glomeruli.
PN is an inflammation of the
IN is a kidney condition characterized by
There can be both acute (sudden) GN and kidney tissue, calyces, and pelvis.
swelling in between the kidney tubules.
chronic (long-term) GN.
Pyelonephritis may be acute or chronic. IN can be sudden (acute) or chronic.
Acute GN can start in response to an
PN is commonly caused by ascending
infection such as strep throat or an
bacterial infection that has spread up
Acute IN is frequently the result of an
abscessed tooth. It may be caused by
the urinary tract or travelled through the allergic reaction. Many of these
problems with your immune system
bloodstream to the kidneys.
medications fall into the following
overreacting to the infection.
categories:
Acute PN results from bacterial
 antibiotics
Glomeruli are enlarged due to
invasion of the renal parenchyma.
 NSAIDs
proliferation of endothelial cells, swelling Bacteria usually reach the kidney by  proton pump inhibitors
of endothelial cells and inflammatory
ascending from the lower urinary tract.
infiltrate (neutrophils and monocytes).
Bacteria may also reach the kidney via
This will result in compression of
the bloodstream.
capillaries and Bowman space which is
reduced in size. Due to some
Chronic PN results from bacterial
immunological processes walls of blood
infections in the kidneys over a period
vessels are damaged.
of years. Each episode of infection may
pass unnoticed but may destroy more
Chronic GN may be caused by
and more areas of tissue.
the acute form of GN
Immune diseases
a genetic disease (Hereditary nephritis
occurs in young men with poor vision and
poor hearing.)
Taking anamnesis,
Kidney ultrasound
Physical examination,
CT
blood test,
Urine test for
creatinine clearance,
total protein in urine
urine concentration
urine red blood cells (RBCs)
urine osmolality
Early symptoms of acute GN include:
fever and chills
The most common symptom of IN is
swelling in the face (edema)
back, side, and groin pain
a decrease in the amount a person
(hematuria) blood in urine (dark, rust- intoxication
urinates.
colored urine)
burning or frequent urination,
Other symptoms include
high blood pressure
painful urination
 fever
fatigue
nausea and vomiting
 blood in the urine (hematouria)
Symptoms of chronic GN include:
blood or protein in urine
high blood pressure
swelling in ankles and face (edema)
frequent nighttime urination
foamy urine (from excess protein)
Treatment
Complications
Prevention
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Antibiotics are the first course of action
against acute pyelonephritis. But the
type of antibiotic depends upon whether
or not the bacteria can be identified. If
the type cannot be identified, a broadspectrum antibiotic will be used.
In some cases, drug therapy is
ineffective. For a severe kidney
infection, the patient may be admitted
to the hospital.
Treatment in the hospital may include
antibiotics IV.
exhaustion
confusion
nausea/vomiting
water retention, swelling
weight gain (from water retention)
feeling bloated
elevated blood pressure
Treatment focuses on the cause of the
problem. Avoiding medications that lead
to this condition may relieve the
symptoms quickly.
Treatment depends on the cause of GN.
When it is caused by an infection,
antibiotics may be prescribed.
Treatment may include drug therapy such
as ACE inhibitors, diuretics, calcium
channel blockers and beta blockers to
Limiting salt and fluid in the diet can
control blood pressure and reduce
reduce swelling and high blood pressure.
abnormal functioning.
Other
medications
such
Limiting protein in the diet can help
as corticosteroids may be prescribed
control the buildup of waste products in
reduce your immune response if your
the blood (azotemia)
immune system is attacking your kidneys.
GN may be treated with the changes in diet
to reduce the work of the kidneys. The
patients may be advised to drink less fluid
and to avoid certain drinks such as alcohol
and drinks with a lot of sodium chloride
(salt) and potassium.
acute kidney failure, acute nephrotic syndrome, pyonephrosis, arteriolosclerotic kidney, chronic urinary tract infections,
congestive heart failure due to retained fluid, hypertension, malignant hypertension.
Seek medical help immediately if a strep
Persons with a history of urinary
In many cases, the disorder can't be
infection is the cause of sore throat.
tract infections should urinate
prevented. Avoiding or reducing your
Control high blood pressure which will
frequently, and drink plenty of
use of medications that can cause this
reduce the risk of causing damage to the
fluids at the first sign of infection.
condition can help reduce your risk.
kidneys from hypertension.
Control levels of blood sugar in order to
prevent diabetic nephropathy.
Nephrotic syndrome
a syndrome characterized by edema and large amounts of protein in the urine and usually increased blood cholesterol.
Nephrotic syndrome can be primary; being a disease specific to the kidneys, or it can be secondary, being a renal manifestation of a
systemic general illness. In all cases, injury to glomeruli is an essential feature.
Primary causes of nephrotic syndrome include: minimal-change nephropathy, focal glomerulosclerosis, mebranous nephropathy,
hereditary nephropathies
Secondary causes include: diabetes mellitus, lupus erythematous, viral infections (eg, hepatitis B, hepatitis C, HIV ) and others.
Definition
Etiology&
pathogenesis
Methods of
diagnostics
Clinical picture
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Treatment
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Complications
Prevention
Nephrotic syndrome develops when there is damage to the glomeruli, the structures in the kidneys that work to filter the blood. This
damage allows proteins in the blood (such as albumin) to leak into the urine, causing increased excretion of protein. Eventually, blood
levels of albumin become reduced. Accompanying abnormalities of kidney function lead to accumulation of fluid in the tissues
(edema).
Urine tests are often done to determine the amount of protein in the urine.
A number of blood tests may be recommended to help determine the underlying cause of nephrotic syndrome to assess the risk of
complications and to evaluate overall kidney function.
Renal (kidney) biopsy is the standard procedure for determining the underlying cause of nephrotic syndrome when a cause cannot be
identified by noninvasive laboratory testing.
edema due to severe retention of body fluid
proteinuria (high level of protein in urine)
high blood pressure
The goals of treatment are to relieve symptoms, prevent complications, and delay kidney damage. For nephrotic syndrome control,
it’s necessary to treat the disorder that is causing it.
ACE inhibitors may also help decrease the amount of protein lost in the urine.
Angiotensin receptor blockers (ARBs) prevent further damage to the glomeruli
Corticosteroids are prescribed to suppress or quiet the immune system.
Medications to reduce cholesterol and triglycerides (usually statins) may be needed.
A low-salt diet may help with swelling in the hands and legs. Diuretics may also help with this problem.
You may need vitamin D supplements if nephrotic syndrome is long-term and not responding to treatment.
Blood thinners may be needed to treat or prevent blood clots.
Acute kidney failure
Atherosclerosis and related heart diseases
Chronic kidney disease
Fluid overload, congestive heart failure, pulmonary edema
Infections, including pneumococcal pneumonia
Treating conditions that can cause nephrotic syndrome may help prevent the syndrome.
Definition
Etiology&
pathogenesis
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Methods of
diagnostics
Clinical picture
Treatment
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Complications
Prevention
Kidney stone disease (urolithiasis)
a disease characterized by the formation of kidney and urinary tract stones formed from constituents of urine. Kidney stones are abnormal, hard, chemical
deposits that form inside your kidneys and urinary tract.
There can be numerous factors that cause kidney stone formation within a person's kidneys. Since kidney stones are caused by an imbalance of water, salts,
minerals and other substances that pass through urine, a lack of drinking plain water is typically the cause of kidney stone formation in most people. Other
factors, like medical conditions or a family history of certain illnesses can also increase a person's risk for developing kidney stones.
Kidney stones can be classified into several types, depending on the main cause of formation:
Calcium stones: Calcium stones are the most common form of kidney stones and are caused when calcium combines with other substances, typically oxalate,
forming a hard crystal. Phosphate and carbonate are other examples of substances that can combine with calcium. These substances can be found in certain
foods, or can be increased within the body due to certain metabolic disorders. This type of kidney stone is more often found in men than women.
Uric acid stones: Individuals who eat high-protein diets, suffer from gout or are constantly dehydrated are likely to form uric acid stones. Men are more likely to
suffer from this form of kidney stone.
Cystine stones: Those who suffer from a hereditary disorder, known as cystinuria, are likely to form cystine stones. Cystinuria is a genetic disorder where there
is too much cystine, an amino acid, present within a person's urine. This type of kidney stone can affect both men and women.
Struvite stones: A struvite stone can form due to an infection, most likely a urinary tract infection. These stones are known to grow in size at a rapid rate,
completely blocking the kidney, bladder or ureter. Women are more likely to suffer from this type of kidney stone than men.
There are other factors and substances responsible for the formation of kidney stones, though the types listed here are the most common.
Kidney stones cause painful problems when they block the flow of urine.
Ultrasound
CT, X-ray of kidneys
Pain in the side and back, directly below the ribs
Abnormal colored urine, particularly brown, pink or red in color
Pain in the lower abdomen and groin as the kidney stone passes
Painful urination
Hematuria
Constant need to urinate
Treatment of kidney stones depends on the size and type of kidney stone. In most cases, no treatment is necessary for smaller stones, and all that is required is
increased water intake to help the stone pass through the urinary tract. Certain medications and pain relievers like NSAIDs or acetaminophen can help relieve
pain or discomfort caused by kidney stones.
For larger kidney stones that are too difficult to pass or may cause further medical complications can be surgically removed. However, there are less invasive
treatments available to help under such circumstances:
Extracorporeal shock wave lithotripsy uses sound waves to break up kidney stones through vibrations. This allows larger kidney stones to be broken down into
smaller stones so they can be passed through the urinary tract with less pain and without further complications
Ureteroscopy consists of a thin, lit tube known as ureteroscope with a camera attached that is inserted through the urethra to locate a kidney stone. Once located,
special tools are used to remove or break the kidney stone into smaller pieces so that it can pass through the urine.
Percurtaneous nephrolithotomy can be used to for larger stones found within or near the kidneys. Stone are removed using an endoscope that is inserted into the
kidney through a small incision.
increased risk for urinary tract infection or exacerbation of a preexisting infection
kidney lesions that can lead to acute renal failure if the stone prevents the elimination of the urine from the kidneys
Drink lots of water
Maintain healthy weight
Drink healthy beverages
Keep on low-salt diet
Avoid alcohol and cigarettes