Alport syndrome

Definition

Nephritis is inflammation of the kidney.

Description

The most prevalent form of acute nephritis is glomerulonephritis. This condition affects children and teenagers far more often than it affects adults. It is inflammation of the glomeruli, or small round filters located in the kidney. Pyelonephritis affects adults more than children, and is recognized as inflammation of the kidney and upper urinary tract. A third type of nephritis is hereditary nephritis, a rare inherited condition.

Causes & symptoms

Acute glomerulonephritis usually develops a few weeks after a strep infection of the throat or skin. Symptoms of glomerulonephritis include fatigue, high blood pressure, and swelling. Swelling is most notable in the hands, feet, ankles and face.

Pyelonephritis usually occurs suddenly, and the acute form of this disease is more common in adult women. The most common cause of this form of bacterial nephritis is the backward flow of infected urine from the bladder into the upper urinary tract. Its symptoms include fever and chills, fatigue, burning or frequent urination, cloudy or bloody urine, and aching pain on one of both sides of the lower back or abdomen.

Hereditary nephritis can be present at birth. The rare disease presents in many different forms and can be responsible for up to 5% of end-stage renal disease in men.

Diagnosis

Diagnosis of nephritis is based on:

• The patient's symptoms and medical history
• Physical examination
• Laboratory tests
• Kidney function tests
• Imaging studies such as ultrasound or x rays to determine blockage and inflammation.

Urinalysis can reveal the presence of:

• Albumin and other proteins
• Red and white blood cells
• Pus, blood or bacteria in the urine.

Treatment

Treatment of glomerulonephritis normally includes drugs such as cortisone or cytotoxic drugs (those that are destructive to certain cells or antigens). Diuretics may be prescribed to increase urination. If high blood pressure is present, drugs may be prescribed to decrease the hypertension. Iron and vitamin supplements may be recommended if the patient becomes anemic.

Acute pyelonephritis may require hospitalization for severe illness. Antibiotics will be prescribed, with the length of treatment based on the severity of the infection. In the case of chronic pyelonephritis, a six-month course of antibiotics may be necessary to rid the infection. Surgery is sometimes necessary.

Treatment of hereditary nephritis depends of the variety of the disease and severity at the time of treatment.

Alternative treatment

Alternative treatment of nephritis should be used as a complement to medical care and under the supervision of a licensed practitioner. Some herbs thought to relieve symptoms of nephritis include cleavers (Galium spp.) and wild hydrangea.

Prognosis

Prognosis for most cases of glomerulonephritis is generally good. Ninety percent of children recover without complications. With proper medical treatment, symptoms usually subside within a few weeks, or at the most, a few months.

Pyelonephritis in the acute form offers a good prognosis if diagnosed and treated early. Follow-up urinalysis studies will determine if the patient remains bacteria-free. If the infection is not cured or continues to recur, it can lead to serious complications such as bacteremia (bacterial invasion of the bloodstream), hypertension, chronic pyelonephritis and even permanent kidney damage.

If hereditary nephritis is not detected or treated, it can lead to complications such as eye problems, deafness or kidney failure.

Prevention

Streptococcal infections that may lead to glomerulonephritis can be prevented by avoiding exposure to strep infection and obtaining prompt medical treatment for scarlet fever or other infection.

Pyelonephritis can best be avoided if those with a history of urinary tract infections take care to drink plenty of fluids, urinate frequently, and practice good hygiene following urination.

Hereditary nephritis can not be prevented, but research to combat the disease continues.

Further Reading

For Your Information

Organizations

• American Kidney Fund. 6110 Executive Boulevard, Rockville, MD 20852. (800) 638-8299.
• National Kidney Foundation. 30 East 33rd Street, New York, NY 10016. (800) 622-9010.

  Other

• Cleavers. http://www.healthy.net/hwlibrarybooks/hoffman/materiamedica/cleavers.htm (14 June 1998).
• Glomerulonephritis. http://www.thriveonline.com/health/Library/illsymp/illness241.html (6 June 1998)
• Glomerulonephritis. http://www.niddk.nih.gov/health/kidney/summary/glomneph/glomneph.htm (7 June 1998).
• Hereditary nephritis. http://www.cc.utah.edu/(cla6202/What.htm (6 June 1998).
• Hydrangea. http://www.healthy.net/hwlibrarybooks/hoffman/materiamedica/hydrangea.htm (14 June 1998).

Gale Encyclopedia of Medicine. Gale Research, 1999.