Nephritis

Nephritis is inflammation of the kidneys and may involve the glomeruli, tubules, or interstitial tissue surrounding the glomeruli and tubules.[1] It is one of several different types of nephropathy.

## Contents

* 1 Types
* 2 Causes
* 3 Mechanism
* 4 Diagnosis
* 5 Treatment
* 5.1 Prevalence
* 6 See also
* 7 References
* 8 External links

## Types

* Glomerulonephritis is inflammation of the glomeruli. Glomerulonephritis is often implied when using the term "nephritis" without qualification.[2]
* Interstitial nephritis (or tubulo-interstitial nephritis) is inflammation of the spaces between renal tubules.[3]

## Causes

Nephritis can often be caused by infections and toxins, but it is most commonly caused by autoimmune disorders that affect the major organs like kidneys.[4]

* Pyelonephritis is inflammation that results from a urinary tract infection that reaches the renal pelvis of the kidney.[5]
* Lupus nephritis is inflammation of the kidney caused by systemic lupus erythematosus (SLE), a disease of the immune system.[6]
* Athletic nephritis is nephritis resulting from strenuous exercise.[7] Bloody urine after strenuous exercise may also result from march hemoglobinuria, which is caused by trauma to red blood cells, causing their rupture, which leads to the release of hemoglobin into the urine.[8]

## Mechanism

Renin–angiotensin system

Nephritis can produce glomerular injury, by disturbing the glomerular structure with inflammatory cell proliferation.[9] This can lead to reduced glomerular blood flow, leading to reduced urine output (oliguria)[10] and retention of waste products (uremia).[11] As a result, red blood cells may leak out of damaged glomeruli, causing blood to appear in the urine (hematuria).[12]

Low renal blood flow activates the renin–angiotensin–aldosterone system (RAAS), causing fluid retention and mild hypertension.[13] As the kidneys inflame, they begin to excrete needed protein from the affected individual's body into the urine stream. This condition is called proteinuria.[14]

Loss of necessary protein due to nephritis can result in several life-threatening symptoms. The most serious complication of nephritis can occur if there is significant loss of the proteins that keep blood from clotting excessively. Loss of these proteins can result in blood clots, causing sudden stroke.[15]

## Diagnosis

The diagnosis depends on the cause of the nephritis, and in the case of lupus nephritis, blood tests, X-rays and an ultrasound can help ascertain if the individual has the condition.[16]

## Treatment

Disease burden of nephritis/nephrosis worldwide in 2004.[17]

no data

less than 40

40–120

120–200

200–280

280–360

360–440

440–520

520–600

600–680

680–760

Treatment (or management) of nephritis depends on what has provoked the inflammation of the kidney(s). In the case of lupus nephritis, hydroxychloroquine could be used.[18]

### Prevalence

Nephritis represents the ninth-most-common cause of death among all women in the US (and the fifth leading cause among non-Hispanic black women).[19]

Worldwide, the highest rates[clarification needed] of nephritis are 50–55% for African or Asian descent followed by Hispanic at 43% and Caucasian at 17%.[20]

The average age of an individual diagnosed with kidney inflammation (in this case, lupus nephritis) is 28.4 years old.[21]

## See also

* Nephrotic syndrome
* Bright's disease
* Goodpasture syndrome

## References

1. ↑ Keto Acids – Advances in Research and Application 2013 Edition p.220e
2. ↑ "Glomerulonephritis: MedlinePlus Medical Encyclopedia". https://medlineplus.gov/ency/article/000484.htm.
3. ↑ "Interstitial nephritis: MedlinePlus Medical Encyclopedia". https://medlineplus.gov/ency/article/000464.htm.
4. ↑ "Acute Nephritis; Nephrosis; Nephritic syndrome information. Patient | Patient". http://patient.info/doctor/acute-nephritis.
5. ↑ "Pyelonephritis: Kidney Infection". http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/pyelonephritis-kidney-infection/Pages/index.aspx.
6. ↑ "Lupus Nephritis". http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/lupus-nephritis/Pages/index.aspx.
7. ↑ "Nephritis Symptoms". http://esagil.org/Nephritis-Description.aspx.
8. ↑ Shinton, N. K. (2007). Desk Reference for Hematology. CRC Press. ISBN 9781420005127. https://books.google.com/books?id=b0aw2SLzZQ8C&q="Mechanical+hemolytic+anemia"&pg=PA591. Retrieved 2019-02-14.
9. ↑ "Glomerular Diseases". http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/glomerular-diseases/Pages/facts.aspx.
10. ↑ "Oliguria: Background, Etiology, Epidemiology". eMedicine. http://emedicine.medscape.com/article/983156-overview.
11. ↑ "uremia | accumulation in the blood of constituents normally eliminated in the urine that produces a severe toxic condition and usually occurs in severe kidney disease". http://www.merriam-webster.com/medical/uremia.
12. ↑ "Hematuria (Blood in the Urine)". http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/hematuria-blood-in-the-urine/Pages/facts.aspx.
13. ↑ Ashar, Bimal; Miller, Redonda; Sisson, Stephen; Hospital, Johns Hopkins (2012-02-20) (in en). Johns Hopkins Internal Medicine Board Review: Certification and Recertification. Elsevier Health Sciences. ISBN 978-0323087988. https://books.google.com/books?id=m3iwi7Wix8kC&pg=PA51.
14. ↑ "Proteinuria". http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/proteinuria/Pages/facts.aspx.
15. ↑ Thomas, Donald E. Jr (2014-05-22) (in en). The Lupus Encyclopedia: A Comprehensive Guide for Patients and Families. JHU Press. ISBN 9781421409849. https://books.google.com/books?id=8V2RAwAAQBAJ&pg=PA205.
16. ↑ "American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis. | National Guideline Clearinghouse". https://www.guideline.gov/summaries/summary/36900?.
17. ↑ "WHO Disease and injury country estimates". World Health Organization. 2009. https://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html.
18. ↑ "Hydroxychloroquine: MedlinePlus Drug Information". https://medlineplus.gov/druginfo/meds/a601240.html.
19. ↑ "Leading Causes of Death - Women's Health USA 2010". http://mchb.hrsa.gov/whusa10/hstat/hi/pages/208lcd.html.
20. ↑ Lerma, Edgar; Rosner, Mitchell (2012-10-28) (in en). Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation. Springer Science & Business Media. ISBN 9781461444541. https://books.google.com/books?id=buSjLdvrwXYC&pg=PA562.
21. ↑ Lupus Nephritis: Practice Essentials, Background, Pathophysiology, 2018-04-22, https://emedicine.medscape.com/article/330369-overview#showall

## External links

Classification|

* MeSH: D009393
* SNOMED CT: 52845002

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| Wikimedia Commons has media related to Nephritis.

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| Scholia has a topic profile for Nephritis.

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* v
* t
* e

Diseases of the urinary system (N00–N39, 580–599)

Kidney disease|

| Glomerules|

| Primarily
nephrotic|

| Non-proliferative|

* Minimal change
* Focal segmental
* Membranous

|

Proliferative|

* Mesangial proliferative
* Endocapillary proliferative
* Membranoproliferative/mesangiocapillary

By condition|

* Diabetic
* Amyloidosis

Primarily
nephritic,
RPG|

| Type I RPG/Type II hypersensitivity|

* Goodpasture's syndrome

|

Type II RPG/Type III hypersensitivity|

* Post-streptococcal
* Lupus
* DPGN
* IgA/Berger's

Type III RPG/Pauci-immune|

* Granulomatosis with polyangiitis
* Microscopic polyangiitis
* Eosinophilic granulomatosis with polyangiitis

General|

* glomerulonephritis
* glomerulonephrosis

Tubules|

* Renal tubular acidosis
* proximal
* distal
* Acute tubular necrosis
* Genetic
* Fanconi syndrome
* Bartter syndrome
* Gitelman syndrome
* Liddle's syndrome

Interstitium|

* Interstitial nephritis
* Pyelonephritis
* Balkan endemic nephropathy

General|

| General syndromes|

* Nephritis
* Nephrosis
* Renal failure
* Acute renal failure
* Chronic kidney disease
* Uremic pericarditis
* Uremia
* Diabetes insipidus
* Nephrogenic
* Renal papilla
* Renal papillary necrosis
* Major calyx/pelvis
* Hydronephrosis
* Pyonephrosis
* Reflux nephropathy

|

Vascular|

* Renal artery stenosis
* Renal ischemia
* Hypertensive nephropathy
* Renovascular hypertension
* Renal cortical necrosis

Other|

* Analgesic nephropathy
* Renal osteodystrophy
* Nephroptosis
* Abderhalden–Kaufmann–Lignac syndrome

Urinary tract|

| Ureter|

* Ureteritis
* Ureterocele
* Megaureter

|

Bladder|

* Cystitis
* Interstitial cystitis
* Hunner's ulcer
* Trigonitis
* Hemorrhagic cystitis
* Neurogenic bladder dysfunction
* Bladder sphincter dyssynergia
* Vesicointestinal fistula
* Vesicoureteral reflux

Urethra|

* Urethritis
* Non-gonococcal urethritis
* Urethral syndrome
* Urethral stricture/Meatal stenosis
* Urethral caruncle

Any/all|

* Obstructive uropathy
* Urinary tract infection
* Retroperitoneal fibrosis
* Urolithiasis
* Bladder stone
* Kidney stone
* Renal colic
* Malakoplakia
* Urinary incontinence
* Stress
* Urge
* Overflow

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