interstitial nephritis
Definition of Nephritis
A kidney disorder caused by inflammation of the tubules and the spaces between the tubules and the glomeruli.
Alternative names
Tubulointerstitial nephritis; Nephritis - interstitial; Acute interstitial (allergic) nephritis
Causes, incidence, and risk factors
Interstitial nephritis involves inflammation of the spaces between the renal tubules and may include inflammation of the tubules. It may be a temporary lesion, most often associated with the effects of various medications on the kidney, or it may be chronic and progressive.
Interstitial nephritis is one of the lesions associated with analgesic nephropathy, and can also occur with allergic reaction to a drug (acute interstitial allergic nephritis) or as a side effect of medications.
Interstitial nephritis causes reduction in kidney function, ranging from mild dysfunction to acute kidney failure. About one-half of the cases will exhibit decreased urine output and other signs of acute renal failure. The kidney may fail to concentrate the urine when water intake is reduced. The kidney may fail to regulate acid/base levels of the body may be reduced, with failure to excrete acid appropriately in the urine. Metabolic acidosis may occur because of the inability to excrete acid. The disorder may progress to chronic renal failure or end-stage renal disease.
The acute form of interstitial nephritis is common and may account for approximately 15% of cases of acute kidney failure. Risks include exposure to medications that may have nephrotoxic effects. The disorder may be more severe and more likely to lead to chronic or permanent kidney damage in the elderly.
Symptoms of Nephritis
- increased or decreased urine output
- fever
- mental status changes, ranging from drowsiness to confusion to coma
- nausea, vomiting
- rash (sometimes)
- swelling of the body, any area
- weight gain (from fluid retention)
- blood in the urine
nephritis - Lupus
Definition
A kidney disorder that is a complication of systemic lupus erythematosus , characterized by damage to the glomerulus and progressive loss of kidney function.
Alternative names
Nephritis - lupus; Lupus glomerular disease
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Causes, incidence, and risk factors
Lupus nephritis is one complication of systemic lupus erythematosus. It is related to the autoimmune process of lupus, where the immune system produces antibodies (antinuclear antibody and others) against body components. Complexes of these antibodies and complement accumulate in the kidneys and result in an inflammatory response.
Lupus causes various disorders of the internal structures of the kidney, including interstitial nephritis, mesangial GN, membranous GN, membranoproliferative GN, diffuse proliferative GN, and others.
It often causes nephrotic syndrome (excessive protein excretion) and may progress rapidly to renal failure. There is progressive azotemia (the accumulation of nitrogenous waste products in the blood stream) and urinary abnormalities including protein and blood in the urine .
Lupus nephritis affects approximately 3 out of 10,000 people. Systemic lupus erythematosus is most common in women, especially those 20 to 40 years old. It has a familial tendency, with a higher incidence in blacks. It may be related to other autoimmune disorders including rheumatoid arthritis and scleroderma . It has been known to be triggered by pregnancy in some cases.
In children with SLE, about 1/2 will have some form or degree of kidney involvement.
Symptoms
- blood in the urine
- foamy appearance to urine
- swelling of any area of the body
- elevated blood pressure
- Symptoms of SLE may include:
- joint pain
- joint swelling
- joint redness
- rash
- commonly on the face but may occur on other areas
- characteristic "butterfly" distribution
- chest pain, sharp and stabbing
- cough
- sun sensitivity
- fever may develop after exposure to sun
- rash may develop after exposure to sun
- fatigue
- mouth ulcers, painless
- neurologic changes
- seizures
- dementia or psychosis
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