Interstitial Nephritis » National Kidney Federation Interstitial Nephritis What is Interstitial Nephritis? Interstitial nephritis is a condition where there is inflammation within the the kidneys. It is the same in both kidneys, and can only be seen under the microscope. There is swelling and scarring inside the kidneys, although this is not usually painful. 'Interstitial' means that the inflammation does not affect the blood vessels or filters in the kidney, but only the parts inbetween them. Nephritis means kidney disease. The next few paragraphs will tell you what causes interstitial nephritis, how it is diagnosed and how it is treated. What Causes Interstitial Nephritis? The immune system. Interstitial nephritis is caused by the body’s immune system (natural defences). The usual job of the immune system is to fight invaders into the body. These might be germs or bugs, or foreign objects such as splinters. The body recognises these invaders, and tries to eliminate them from the body. The blood contains two main types of defence system. One is white blood cells, which stick to germs and kill them.

The other type of defence is antibodies, which are smaller than the white blood cells, and by sticking onto germs either make them burst apart, or help the white blood cells to stick to them. The immune system is very powerful, and is normally very good at recognising what is part of the body and what is not. However, sometimes it makes a mistake and attacks the body as if that part of the body was an invader. There are many different diseases caused by the immune system, and they can affect any part of the body. There are several kidney diseases caused by the immune system. Some of them affect only the kidneys, some can affect other parts of the body as well as the kidneys. It is not clear why the immune system causes diseases such as interstitial nephritis. There may be some trigger that makes the immune system go wrong, such as an infection. Sometimes interstitial nephritis can be caused by a drug. Often it is not known why interstitial nephritis occurs. Infections and other causes of interstitial nephritis. Some infections, including tuberculosis, can cause interstitial nephritis, and doctors will test for this and other infections in patients with interstitial nephritis.

Rarely, interstitial nephritis can be seen with diseases that affect other parts of the body, and the kidney specialist will check for these. How is Interstitial Nephritis Diagnosed? Interstitial nephritis is usually suspected because blood tests show an abnormality in the kidney function. Urine and X-ray tests are first performed to make sure there is no infection or blockage to the flow of urine. If this does not explain the kidney disease, a kidney biopsy is then performed. A biopsy is the removal of a fragment of kidney with a needle. When the kidney tissue is examined under a microscope, interstitial nephritis may be diagnosed. What are the Symptoms of Interstitial Nephritis? There are often no symptoms directly connected with the kidneys. It is rare to have pain. Urine is usually passed in normal quantities even when the kidneys are removing little waste product from the body. It is common to pass more urine at night. In some cases the urine volumes are excessive so you feel dry and thirsty all the time. Interstitial nephritis can damage the kidneys so much that kidney failure develops. This is a severe build up of waste products in the body. If severe kidney failure develops, tiredness, sickness, vomiting and itching may occur.

In some people with interstitial nephritis the the bowel is affected by inflammation as well as the kidneys. If this is the case, there may be tummy pain or vomiting. In severe cases there may be vomiting of blood. Rarely there is also a blotchy red rash on the skin. What is the Treatment for Interstitial Nephritis? It often gets better on its own, especially if the interstitial nephritis was due to a drug that has been stopped. However, in many cases recovery is not immediate and the kidney specialist will consider giving you a course of tablets called steroids (prednisolone). Click here for more details about steroids. The value of steroids in interstitial nephritis has not been proven conclusively by research, so that most doctors are cautious about starting this treatment. Steroids may help some, but not all, cases of interstitial nephritis. The problem with steroids is the risk of side effects (reduced resistance to infection, weight gain and so on), so that the value of steroids needs to be evaluated in individual cases. Will the Kidneys get Better? In most cases, some scarring develops in the kidneys, causing permanent damage. However, this may remain stable for years without causing problems.

In some cases, however, the kidneys are so badly damaged that they fail completely and dialysis will need to be considered. Is Interstitial Nephritis Infectious? No. Although interstitial nephritis can be triggered by a viral infection, it is not infectious because the problem is your body's reaction to the infection, not the type of infection itself. So if your partner or a family member has the same infection that triggered your interstitial nephritis, they will not get interstitial nephritis themselves. Is Interstitial Nephritis Inherited? EdRen - Edinburgh Royal Infirmary Renal Unit - More info on interstitial nephritis More info on interstitial nephritis Edren is now Mobile-friendly ... more Glasgow Bridges walk Sun 9th Oct ... more Got PKD? New treatment becoming available ... more 50th islet cell transplant ... more IV saline 1832-2013 ... more The interstitial part of the kidney is made up of the tubes (tubules) that lead from each filtering unit (glomerulus) (see normal kidneys for a diagram of a nephron - a glomerulus and its tubule).

The coils of these tubes surround the glomeruli, so they can become involved if the glomeruli are diseased. The tubules and the interstitium can also suffer from some diseases of their own. This page describes some of these conditions. Other interstitial kidney diseases including RTA, Fanconi Syndrome Acute intersitial nephritis (AIN) This means that the tubules are inflamed. Like most diseases affecting the kidney, it produces very few symptoms unless the kidneys are quite severely affected. Blood tests will show that kidney function is not normal. Urine tests in interstitial nephritis often show only minor abnormalities, but the urine may contain white blood cells as if it was infected. Most commonly AIN is an allergic reaction to something, often a medicine. Antibiotics and anti-inflammatory painkiller drugs are common causes of this. It can occur after taking some non-prescription medicines, such as ibuprofen (Nurofen, and other trade names). We have a separate page that gives a short summary of information on AIN . Causes of Acute Interstitial Nephritis (AIN) Allergic - commonly a reaction to a drug. If it does not improve quickly after stopping the drug, this often responds to treatment with steroids .

There is a very long list of drugs that can occasionally cause AIN. Infection - some infections can cause interstitial nephritis. Poisons - while acute tubular necrosis (see below) is more common with poisons, some may cause inflammation, although this is usually chronic ( see below ). Autoimmune diseases - sometimes inflammation is caused by your own immune system attacking the kidney. This is the most common cause of inflammation of the glomeruli but can also affect tubules. These are some types of autoimmune inflammation that can do this: AIN alone Autoimmune AIN may occur on its own, or together with inflammation of the eyes - so-called TINU syndrome, which stands for tubulointerstitial nephritis and uveitis. As part of another autoimmune disease - AIN may also occur as part of Sjogren's syndrome (a condition in which eyes and mouth become dry among other changes), and sometimes with autoimmune disorders affecting other parts of the body. Sarcoidosis - an unusual condition, often with inflammation in the lungs, and with a high level of calcium in the blood. Most people with sarcoidosis have lung disease and it affects the kidneys in only a few.

Chronic interstitial nephritis Chronic means something that continues without going away. It usually means that there is likely to be permanent scarring and damage even if the cause is taken away. Like acute intersitial nephritis, it has no symptoms until there is quite a lot of kidney damage. Some of the causes will cause other symptoms, however, and the kidney trouble may then be picked up on blood and urine tests. Causes of Chronic Interstitial Nephritis Causes of Acute Interstitial Nephritis - commonly a reaction to a drug. If it does not improve quickly after stopping the drug, this often responds to treatment with steroids . Myeloma - Myeloma is a type of cancer of white blood cells. It often develops very slowly, and it can be treated. Some of the white blood cells that make antibodies overproduce a particular antibody. Fragments of these antibodies ('light chains', also called Bence Jones protein) leak into the urine and are toxic to the tubules. Further (detailed) information from the NKF Poisons - a variety of different types. Lead poisoning is one example - fortunately this is rare now. Various kinds of poisonous mushrooms and herbs may also do this. Drugs - some antibiotics (e.g.

amphotericin, gentamicin) and some types of chemotherapy (e.g. cisplatin) can cause interstitial nephritis. Inherited - rarely this type of kidney disease can run in families Unknown - unfortunately it is often not possible to find a cause. This type of disease seems to be particularly common as a cause of renal failure in patients of Asian race within the UK. Acute tubular necrosis This is the name given to a temporary injury to the kidney, in which many cells in the tubules die, but the tubules recover after a period lasting days to weeks. Dialysis treatment is often required to maintain health until recovery occurs. Acute Tubular Necrosis (ATN) is usually caused by some combination of the following: very low blood pressure (eg caused by severe bleeding) severe infection - usually with very low blood pressure toxicity from drugs, chemicals, or infection Many patients with acute tubular necrosis develop it in hospital as a complication of a severe illness or a major operation. The diagnosis of acute tubular necrosis is therefore usually quite obvious No treatment has been found to speed recovery. It is a matter of waiting. In very severe cases the damage is sometimes not reversible.

Other interstitial kidney diseases The inherited condition polycystic kidney disease , and some other diseases causing cysts to form in the kidneys, affect the interstitium. In renal tubular acidosis and some inherited conditions there is a problem with the way that tubules work. Sometimes this is due to diseases that cause interstitial nephritis, but sometimes these abnormalities occur on their own. Each of these is different and many of them are quite complicated. In renal tubular acidosis there is a problem with getting rid of acid. In the most common form, formation of kidney stones can be a problem. In Fanconi syndrome the renal tubules don't work properly and you may lose more sodium, potassium, phosphate, bicarbonate and some other things into urine than normal. They may then need to be supplemented by pills or diet. Acknowledgements: The author of this page was Neil Turner. It was first published in August 2001. The date is was last modified is shown in the footer. Nephritis Home Remedies: Natural Treatment for Nephritis Issues | Natural Remedies.org Conditions Nephritis The kidneys play a huge role in the body.

Not only do the kidneys remove waste from the body, but they also maintain fluid and electrolyte balance, and are able to respond to different body needs by either concentration or diluting urine. The kidneys also secrete hormones that are important to many different physiological functions of the body, such as rennin, which regulates blood pressure. The kidneys are vital to the human body and each body must have at least one good kidney in order to function. Nephritis is general inflammation of one or both of the kidneys. It is not a disease itself but rather a symptom of a bigger problem. It can affect both young and old alike. The inflammation can be caused by many different things. There are two classifications of nephritis; acute and chronic. If symptoms appear very quickly, the nephritis is classified as acute. If symptoms develop very slowly over a long period of time, the nephritis is called chronic. In addition to the two different classifications of nephritis, there are also many different types of nephritis. These include: Glomerulonephritis – This is characterized by inflammation of the glomerulus, which is a tuft of capillaries that carries out the first steps of filtering the blood. This is usually caused by an autoimmune disease or an infection.

Lupus nephritis – This is inflammation of the kidney caused by systemic lupus erthematosus, which is an immune system disease. Pyelonephritis – This is a kidney infection from bacteria that usually spreads to the kidneys from the bladder. Interstitial Nephritis – This is an inflammation of kidney cells that are non fluid-collecting. In about 60 per cent of adults and 90 per cent of children, nephritis will completely resolve. It can come and go many times in any individual’s life and cause only mild or no pain. Symptoms of Nephritis Chronic nephritis can fail to show symptoms for up to thirty years. When symptoms are present, they commonly appear as: Feeling the need to urinate often Cloudy or bloody urine A buildup of fluid in the tissues which causes swelling. This is a symptom known as edema. Loin pain Age Trauma Certain diseases, such as AIDS, cancer, sickle cell anemia, systemic lupus erthematosus, hepatitis C, and congestive heart failure. Bacterial infection Preventing Nephritis There are many different ways to prevent or reduce the risk of most kinds of nephritis.

Even if a person has a disease which makes nephritis more likely, there are steps that can be taken to reduce the chances of developing it. If you have diabetes, keep a very good watch on your blood sugar. If you have high blood pressure, there are certain medications that can be prescribed to keep it lower. Follow the doctor’s orders about how often and how much of the pills to take, even if your blood pressure seems to be under control. Some of these medications actually work to protect the kidney as well as lower blood pressure. If you suspect you may have a blocked renal artery, see a doctor. Sometimes, blockages can be opened or repaired, or kidney stones removed if they are the cause of the blockage. Cut back on the amount of painkillers you take. The painkillers that are bad for the kidneys include ibuprofen, naproxen, and acetaminophen. Don’t use illegal drugs. If your family has a history of kidney problems, have regular checkups to hopefully catch any issues early on. If you contract strep throat, get proper treatment so it doesn’t develop into nephritis. If you have any signs of kidney damage, see a doctor quickly.

It is much easier to treat kidney damage in early stages of the disease than it is in the later stages. Diagnosing Nephritis If a patient has the symptoms of nephritis, a doctor will order a couple different lab tests. The purpose of the tests is to find out why the kidney are be swollen. Kidneys don’t just swell up on by themselves; there is a cause, it may just be hard to find. The doctor will test the urine for an infection or for protein. He or she will also test the blood. The blood test will measure how much urea and creatinine are in the blood. This will tell the doctor if the kidneys are filtering well or not. A physical exam can be done to determine if the either of the kidneys are in fact inflamed. Ultrasounds, CT scans, and MRIs can all be done to look at the kidney and see how big the kidneys actually are. These tests also allow the doctor to estimate how much blood is getting to the kidneys and see any blockages. Another test that may be done is a kidney biopsy. In a biopsy, the doctor takes a small sample of kidney tissue and tests it to figure out what is causing the swelling.

The doctor may do other tests if he or she suspects something different then a kidney disease. Treating Nephritis Since nephritis is caused by some other condition besides the actually inflammation itself, the main course of treatment is to fix the underlying problem. Diabetes and hypertension (high blood pressure) are the two most common causes for nephritis. If either of these are the problems, there are a couple things that can be done. If the person is overweight, the doctor may suggest losing weight to help manage the blood pressure or diabetes. Also, the doctor will suggest that the patient watches his or her blood pressure or blood sugar very closely. It is important for both of them to stay in the right ranges. Regular exercise and a good diet are important parts of slowing down or treating a kidney disease. Abstaining from tobacco, smoking, and alcohol are also good ideas. There are many ways to treat nephritis at home. These methods are pretty cheap and consist of going to the local grocery store and shopping around the produce section. Here is a list of some of the suggested methods: Carrot juice: mix a glass of carrot juice with a tablespoon of honey and a bit of fresh lime juice. Drink this first thing in the morning.

This is said to be one of the most effect ways to treat nephritis at home. Banana: since bananas are low in protein and salt and high in carbohydrates, they are good for treating nephritis. Avocado: Avocados have a lot of minerals and not much protein, so they are also helpful for treating nephritis. Grapes: Grapes have low albumin and low sodium chloride, so they are good to eat during any kind of kidney disease process. Coconut Water: The water of one green coconut, taken twice a day, is a very safe diuretic. It is also suggested that a person with nephritis go on a fruit juice only diet for around 9 days. After the fruit juice diet, there should be six days of a fruit and fruit juice diet, followed by 4 days of a juice only diet. Herbal Remedies for Nephritis Wild Yam Root is a good way to naturally treat nephritis. It is available in supplement form for about $6 a bottle. Some people do have mild side effects from the root, including nausea, and it is not tested for pregnant women.

It has been proven to interact with some hormone therapies, so contact a doctor before starting a Wild Yam Root supplement if you are on any type of hormone medication. Nettle seed tincture is another herb that can be used to treat nephritis. Astragalus root and cooked rehmannia root mixed together seem to be an effect way to improve a diseased kidney. There are many supplements available with the two ingredients, among other things. The supplements are available for about $15 a bottle. Salvia root has been proven to help with nephritis. Some people experience dry mouth, dizziness, weakness, edema in the hands and feet, shortness of breath, gastrointestinal problems, nausea, a fast heart beat, vomiting, and anxiety. The symptoms are usually very temporary. One hundred grams of salvia costs about $12. Medicine used to treat nephritis Generally, medicine prescribed when a patient has nephritis is to treat the cause of the inflammation. For example if a person has high blood pressure, they will be given pills to lower the blood pressure. The pills usually prescribed for blood pressure control when nephritis is a symptom are thaizide diuretics and beta blockers.

Other medications prescribed are diuretic or anti-inflammatory medications. Diuretics work to get rid of excess fluid. If nephritis is caused by a bacterial infection, antibiotics will be used to treat the cause. If the disease gets to the point where one or both kidneys are not functioning, dialysis may be needed. Dialysis is a process where toxins are cleansed from a person’s blood. Normally, the kidney does this job, but if the kidney is diseased, it may not be able to perform this task. Dialysis normally takes three to four hours, and usually is done in a hospital. Treatments cost around $44,000 per year. If a kidney’s efficiency drops down to 15 per cent or less, a transplant may be needed. To be a candidate for a transplant, the heart and lung should be working well, the patient must be willing to follow a strict regiment before and after surgery, and the infection must be gone. Transplants can cost as much as $38,000. Nephritis_TCM-Kidney Disease Treatment Step 5: Immune protection. Step 6: Immune clearance.

If you have been diagnosed with nephritis , we're here to help. Email us: alisa1053360918@yahoo.com (Monday through Sunday) to make an appointment. ● Urine test A urine analysis may show red blood cells or red blood casts in the urine, which indicates the possible damage to the glomeruli. This test may also show white blood cells (indicator of inflammation) and increase protein (indicator of nephron damage). ● Blood tests These can provide information about damage of the kidneys and the glomeruli by measuring levels of wastes like creatinine and BUN. ● Kidney biopsy A biopsy involves using a special needle to extract small pieces of renal tissue for microscopic examination to help determine the cause of the inflammation. It is necessary to confirm the diagnosis of Nephritis. ● Imaging Studies such as ultrasound or x rays can determine blockage and inflammation. After detecting the evidence of damage, the doctor may recommend imaging test such as a kidney X-ray, an ultrasound examination or a CT scan. If you have been diagnosed with nephritis , we're here to help. Email us: alisa1053360918@yahoo.com (Monday through Sunday) to make an appointment.

Prevent Here are certain steps that people can follow for nephritis prevention, some of which include avoiding people with a strep throat, following a proper diet, drinking at least 12 glasses of water a day, exercising every day and getting an adequate amount of rest. Nevertheless it is possible to suffer from nephritis, in spite of following these measures. Prognosis The 'prognosis' of Nephritis usually refers to the likely outcome of Nephritis. The prognosis of Nephritis may include the duration of Nephritis, chances of complications of Nephritis, probable outcomes, prospects for recovery, recovery period for Nephritis, survival rates, death rates, and other outcome possibilities in the overall prognosis of Nephritis. Naturally, such forecast issues are by their nature unpredictable. If you have been diagnosed with nephritis , we're here to help. Email us: alisa1053360918@yahoo.com (Monday through Sunday) to make an appointment. Diet ● Increase your intake of water and make sure that you consume no less than 8 to 10 glasses a day, as it flushes the toxins out of your body.

● Avoid foods that contain high amounts of oxalic acid, which is found in spinach, rhubarb, chocolate or other products made from cocoa. ● Cut down on your intake of salt, which means that you need to stay away from processed meat, junk food and instant foods. ● Eliminate fried food from your diet completely for a while, at least till you recover from this condition. Fruit ● One of the most effective remedies for Nephritis is to mix a glassful of carrot juice with one tablespoon of honey. This juice should be taken everyday in the morning before breakfast. ● Bananas have also been found to be beneficial for treating Nephritis because of their high carbohydrate content and low protein and salt content. For this purpose a diet of bananas should be taken for about three days by consuming about seven bananas per day. Sports It is important that a person suffering from nephritis should not exert himself while engaging in any physical activity. However, there are many exercises that are quite mild and gentle and while they allow you to enjoy all the benefits that have been associated with exercising, they do not put too much strain on your body. Start by walking at least three kilometers once a day and increase the amount you walk gradually.

Try to get as much fresh air as possible, as it has an excellent effect on your overall health. You could walk in a park or an open area that is not polluted. In case you’d like to engage in other aerobic exercises, it is best to get an approval from a doctor first. Also make sure that you get the amount of rest required by your body, on a daily basis. Habit If you have the habits of drinking alcohol or smoking, you need to give up on these practices immediately. Both drinking and smoking can have an adverse effect on all the organs of your body, including the kidneys. If you have been diagnosed with nephritis , we're here to help. Email us: alisa1053360918@yahoo.com (Monday through Sunday) to make an appointment. Any questions? Fill the form below. You will surely get the free medical advice from experts within 24 hours. Name: Interstitial nephritis Interstitial nephritis is a kidney disorder in which the spaces between the kidney tubules become swollen -LRB- inflammed -RRB- . Interstitial Nephritis This is a kidney disorder caused by inflammation of the tubules and spaces between the tubules and glomeruli.

It is common for people with lupus to develop a kidney disorder called "lupus nephritis" (which really just means kidney disorder caused by lupus!). The inflammation can affect the kidneys ' ability to filter waste . Overview Interstitial nephritis can cause mild to severe kidney problems , including acute kidney failure . In about half of cases , people will have decreased urine output and other signs of acute kidney failure.Symptoms of this condition include : Blood in the urineFeverIncreased or decreased urine outputMental status changes -LRB- drowsiness , confusion , coma -RRB- Nausea , vomitingRash -LRB- sometimes -RRB- Swelling of the body , any areaWeight gain -LRB- from retaining fluid -RRB- Symptoms Treatment focuses on the cause of the problem . Avoiding medications that lead to this condition may relieve the symptoms quickly.Limiting salt -LRB- sodium -RRB- and fluid in the diet can control swelling and high blood pressure .

Also limiting protein can help control the buildup of waste products in the blood -LRB- azotemia -RRB- that can lead to acute kidney failure.If dialysis is necessary , it usually is required for only a short time.Corticosteroids or anti - inflammatory medications can help in some cases . either a nephritis (inflammation of the kidney where you'll see some blood and some protein in the urine) and a nephrosis (non-inflammatory kidney illness where there is tons of protein in the urine, but no blood) Treatment Interstitial nephritis may be temporary -LRB- acute -RRB- or it may be chronic and get worse over time.The following can cause interstitial nephritis : Allergic reaction to a drug -LRB- acute interstitial allergic nephritis -RRB- Analgesic nephropathySide effect of certain antibiotics -LRB- penicillin , ampicillin , methicillin , sulfonamide medications , and others -RRB- Side effect of medications such as nonsteroidal anti - inflammatory drugs -LRB- NSAIDs -RRB- , furosemide , and thiazide diureticsThe acute form of interstitial nephritis is common .

It is most often caused by side effects of certain drugs . This disorder may be more severe and more likely to lead to chronic or permanent kidney damage in elderly people . Causes An exam may show edema or too much fluid . The health care provider might hear abnormal sounds when listening to the heart or lungs with a stethoscope -LRB- auscultation -RRB- . Blood pressure commonly is high.Common tests include : Arterial blood gases and blood chemistryBUN and creatinine levelsComplete blood countKidney biopsyRed blood cell count - urineUrinalysisUrine pHUrine specific gravity and osmolalityWhite blood cell count The list could include diabetes, nephritis and kidney disease, chronic high blood pressure, some sort of immune disorder, and some others that I can't think of. Tests & diagnosis Most often , interstitial nephritis is a short - term disorder . In rare cases , it can cause permanent damage , including chronic kidney failure . I have recently been given a new Dx to add to the list...the docs call it chronic lithotripsy induced nephritis. 7 major open surgeries for kidney stone removal (some stones were bigger than a quarter). Prognosis In many cases , the disorder ca n't be prevented .

Avoiding or reducing your use of medications that can cause this condition can help reduce your risk . Prevention Metabolic acidosis can occur because the kidneys are n't able to remove enough acid . The disorder can lead to acute or chronic kidney failure or end - stage kidney disease . Analgesic nephropathy is a chronic kidney disease that gradually leads to end-stage renal disease and the permanent need for dialysis or a kidney transplant to restore renal function. Complications Call your health care provider if you have symptoms of interstitial nephritis.If you have interstitial nephritis , call your health care provider if you get new symptoms , especially if you are less alert or have a decrease in urine output . About half of the people with interstitial nephritis experience a decrease in urine output. Other Discussions Symptoms of Chronic Interstitial Nephritis Symptoms of Chronic Interstitial Nephritis 2013-03-23 16:32 Chronic interstitial nephritis is a type of kidney disorder in which the kidney interstitium is inflamed.This can cause problems with the way your kidneys work,resulting in a myriad of symptoms.What are the common symptoms of chronic interstitial nephritis?

Fever Infection is a common cause of chronic interstitial nephritis like pyelonephritis.If chronic interstitial nephritis is related to infection, the patients will experience fever. Blood in the urine Blood in the urine can be seen the the symptoms of chronic interstitial nephritis.If there is a large amount of blood in the urine, the urine will become pink, red or cola-colored. Rash Autoimmune disorders such as anti-tubular basement membrane disease, Kawasaki’s disease, systemic lupus erythematosus,etc.If chronic interstitial nephritis is associated with lupus, rash can appear on various parts of the body. Swelling and weight gain Healthy kidneys can filter wastes and extra fluids from body. In chronic interstitial nephritis, high levels of fluids will build up in body, thus resulting in retention fluids. Swelling and weight gain will be the result. Symptoms of allergy If chronic interstitial nephritis is caused by allergic reaction to drugs, the patients will experience the following symptoms. * Approximately 60~100% of the patients have fever. * About 30~40% have rash, itching. * Occasionally, back pain can occur. It may be related to tension of renal capsule.

* About 1/3 of the patients have gross hematuria. Increased creatinine and BUN If chronic interstitial nephritis can not be controlled effectively, it will result in progressive renal function deterioration. As a result, high levels of toxins will build up in blood, leading to increased creatinine and BUN. Due to powerful compensatory capacity of the kidneys, the levels of serum creatinine and BUN does not increase until more than half of the renal function is lost. The above are the common symptoms of chronic interstitial nephritis. If left untreated or treated ineffectively, it will progress into Kidney Failure . Therefore, it is important for the patients to seek for timely and effective treatment. Nephritis - body, causes, Pollys Sore Throat, What Is Nephritis? Nephritis Nephritis Nephritis (nef-RY-tis) is an inflammation of one or both kidneys that can result in kidney damage. KEYWORDS for searching the Internet and other reference sources Bright's disease Renal disease Polly's Sore Throat Polly will always remember fifth grade because she missed so much of it.

She missed one week of school because she had strep throat, a sore throat caused by streptococcal bacteria. Several weeks later, Polly felt very tired, she lost her appetite, her abdomen and back hurt, and her face looked puffy. She rarely had to urinate, and when she did, her urine was dark like cola. Polly's doctor suspected that she had a case of acute (sudden) nephritis that was caused by her strep throat. He explained that her kidneys were not working properly and that waste products from the cells were building up inside her body. Polly's condition got worse. She spent several days in the hospital, then she recovered at home for several weeks. What Is Nephritis? The kidneys play an important role in filtering about 400 quarts of blood a day to remove cellular waste products and extra water. Each of the two bean-shaped kidneys is made up of about one million units called nephrons (NEF-rons). Each nephron consists of a collecting tubule that will eventually take wastes to the bladder, and a filtering unit called a glomerulus * .

* glomerulus (glom-ER-you-lus) is from a Greek word meaning "filter." The glomerulus is a knot of blood vessels that have the job of filtering the blood. 175 Years Ago: Richard Bright Richard Bright, a British physician who lived from 1789 to 1858, was the first to describe the kidney disorder known today as Bright's disease, or nephritis. Bright studied kidney function and was meticulous in his clinical observations. He worked with kidney patients, studying their symptoms, and then he correlated symptoms with the kidney defects he observed during autopsies (examinations after death). The results of Bright's research first appeared in Reports of Medical Cases in 1827. Bright also contributed to the study of lung disease, heart disease, various fevers, and tumors. In a person with nephritis, the glomeruli (plural of glomerulus) do not function properly, often as a result of a bacterial infection like Polly's. Not all the glomeruli are damaged to the same degree, however, so the kidneys can continue to function, but not as well as before. The kidneys may already be affected before the person notices symptoms.

Glomerulonephritis (Bright's disease) There are several different types of nephritis. One of the most common is glomerulonephritis (glomer-u-lo-ne-FRY-tis), also called Bright's disease, a condition in which the glomeruli become inflamed and scarred. Common symptoms of this disease include tiredness, high blood pressure, and swelling of the hands, feet, ankles, and face. This swelling is called edema (e-DEE-ma). The person will pass blood and protein in the urine. Acute nephritis Another type of nephritis that commonly affects children occurs as a result of infection. Sometimes a bacterial infection can spread from another part of the body, such as the bladder, to the kidney. The body's disease-fighting proteins, or antibodies, can adhere to the glomeruli, causing them to become inflamed. This type of nephritis usually is acute, or sudden, and many affected children recover without long-term kidney damage. Other causes Nephritis can occur as a side effect of other diseases, such as diabetes * , and of autoimmune disorders such as systemic lupus erythematosus * .

Nephritis also can be caused by the overuse of certain common drugs, such as ibuprofen (i-bu-PRO-fen) and acetaminophen (a-set-a-MIN-a-fen), and by sniffing glue or inhaling gasoline. What Happens When People Have Nephritis? Symptoms Acute nephritis is characterized by fatigue, loss of appetite, abdominal and back pain, and edema. People with chronic nephritis might not show any outward symptoms. However, protein and red blood cells can usually be seen when a doctor examines their urine under a microscope. If left untreated, chronic nephritis may cause a drastic reduction in kidney function, and the patient's kidney tissue will deteriorate. The patient may develop high blood pressure and may die either from kidney or heart failure. Treatment To treat acute nephritis, the doctor may prescribe anti-biotics to treat infection, anti-inflammatory drugs to reduce symptoms of inflammation, and diuretics to reduce edema. Chronic nephritis cannot be cured, but it can be treated. The goal of treatment is to slow the deterioration of the kidneys. Drugs may be used to treat high blood pressure and a special diet may be prescribed to relieve the load on the kidneys.

People with an overactive immune system that triggers nephritis may be given immunosuppressant drugs to slow down the attack on the kidneys by the immune system. * diabetes (di-a-BEE-teez) is an impaired ability to break down carbohydrates, proteins, and fats because the body does not produce enough insulin or cannot use the insulin it makes. * systemic lupus erythematosus (sis-TEM-ik LOO-pus er-i-them-a-TO-sus), sometimes just called lupus, is a chronic inflammatory disease that can affect the skin, joints, kidneys, nervous system, membranes lining body cavities, and other organs. Nephritis can lead to kidney failure, in which case dialysis or a kidney transplant is required. Dialysis is a procedure in which blood is passed through a machine to filter out waste products and extra water, then returned to the person's body. A kidney transplant is a procedure in which a diseased kidney is surgically replaced with a healthy kidney from a compatible donor. See also How does interstitial cystitis/painful bladder syndrome affect the body?

- Interstitial Cystitis (Painful Bladder Syndrome) - Sharecare Interstitial Cystitis (Painful Bladder Syndrome) How does interstitial cystitis/painful bladder syndrome affect the body? Topics | Kidney Disease and Urology | Interstitial Cystitis (Painful Bladder Syndrome) | How does interstitial cystitis/painful bladder syndrome affect the body? A Answers (1) A Honor Society of Nursing (STTI) answered Interstitial cystitis/painful bladder syndrome can affect the body in a variety of ways. IC/PBS can cause the wall of the bladder to stiffen and hold less urine. This will result in the need to urinate more frequently. Additionally, the chronic pain and discomfort sometimes caused by IC/PBS may lead to depression in some people. IC/PBS, however, has not been proven to increase a person's risk of bladder cancer or to cause complications during pregnancy. Tubulointerstitial Nephritis: Background, Pathophysiology, Etiology Tubulointerstitial Nephritis Author: A Brent Alper, Jr, MD, MPH; Chief Editor: Vecihi Batuman, MD, FASN more...

Share Overview Background The term tubulointerstitial is used to broadly refer to kidney diseases that involve structures in the kidney outside the glomerulus. These diseases generally involve tubules and/or the interstitium of the kidney and spare the glomeruli, as shown in the image below. Kidney biopsy. This is an example of acute interstitial nephritis. The renal cortex shows a diffuse interstitial, predominantly mononuclear, inflammatory infiltrate with no changes to the glomerulus. Tubules in the center of the field are separated by inflammation and edema, as compared with the more normal architecture in the right lower area (periodic acid-Schiff, 40 X). View Media Gallery Although primary glomerular diseases are often associated with prominent tubulointerstitial changes (see the following image), the clinical presentation is dominated by the consequences of glomerular injury; hence, they are not considered in this article. Kidney biopsy in interstitial nephritis. Acute crescentic glomerulonephritis. The glomerular tuft is compressed by the proliferation of epithelial cells, forming a crescent.

The interstitium shows mononuclear inflammatory infiltrate and edema (periodic acid-Schiff, 40 X). Next: Pathophysiology Acute and chronic tubulointerstitial diseases are the result of the interplay of renal cells and inflammatory cells and their products. Lethal or sublethal injury to renal cells leads to expression of new local antigens, inflammatory cell infiltration, and activation of proinflammatory and chemoattractant cytokines. These cytokines are produced by inflammatory cells (ie, macrophages, lymphocytes) and also by the renal cells (ie, proximal tubule, vascular endothelial cells, interstitial cells, fibroblasts). The outcome can be acute or chronic nephritis. In acute interstitial nephritis, the tubular damage leads to renal tubular dysfunction, with or without renal failure. Regardless of the severity of the damage to the tubular epithelium, the renal dysfunction is generally reversible, possibly reflecting the regenerative capacity of tubules with preserved basement membrane. Conversely, chronic tubulointerstitial nephritis is characterized by interstitial scarring, fibrosis, and tubule atrophy, resulting in progressive chronic renal insufficiency.

[ 1 , 2 ] The principal mechanism in acute tubulointerstitial nephritis is hypersensitivity reaction to drugs such as penicillins, nonsteroidal anti-inflammatory drugs (NSAIDs), and sulfa drugs. Another mechanism is acute cellular injury caused by infection, viral or bacterial, often associated with obstruction or reflux. The kidney is remarkably resistant to structural damage in bacterial infections, and, in the absence of obstruction, damage from bacterial infection in the kidney parenchyma is extremely unlikely to occur. Studies have revealed transforming growth factor–beta (TGF-β) as a major participant in fibrogenesis. TGF-β favors accumulation of collagen and noncollagen basement membrane components by direct stimulation of production and by inhibiting matrix degradation enzymes such as collagenases and metalloproteinases. Activation of nuclear transcription factors, such as nuclear factor kappa B (NFκB) in injured kidney cells, [ 3 ] with consequent transcription and release of proinflammatory cytokines into the interstitium, appears to be a major mechanism of chronic tubulointerstitial inflammation accompanying proteinuric kidney diseases.

Previous Next: Etiology Tubulointerstitial diseases of the kidney encompass diverse etiologies and pathophysiologic processes, and the patient can present with acute or chronic conditions. Many forms of tubulointerstitial injury involve exposure to drugs or other nephrotoxic agents such as heavy metals and, rarely, infection. By far the most common form of tubulointerstitial inflammation is hypersensitivity reaction to medications, termed allergic interstitial nephritis.

The following are causes of acute tubulointerstitial nephritis: Hypersensitivity reactions: Any drug can cause an acute allergic reaction involving the kidneys (eg, penicillins, sulfa drugs, nonsteroidal anti-inflammatory drugs [NSAIDs] most common) (See Clinical.) Immunologic diseases (eg, associated with lupus, Goodpasture syndrome) Acute transplant rejection Infections, including bacterial (must be accompanied by obstruction or reflux), viral (eg, cytomegalovirus [CMV], hantavirus, human immunodeficiency virus [HIV], hepatitis B [HBV]), fungal (eg, histoplasmosis), and parasitic (eg, Leishmania, Toxoplasma) The following are causes of chronic tubulointerstitial nephritis: Drugs (eg, analgesics, lithium, cyclosporine, tacrolimus) [ 4 ] Heavy metals (eg, lead, cadmium, mercury) Obstructive uropathy, nephrolithiasis, reflux disease Immunologic diseases (eg, lupus, Sjögren syndrome, primary glomerulopathies, sarcoidosis, vasculitis, antineutrophil cytoplasmic

 antibody [ANCA]–associated vasculitides, Wegener granulomatosis, and chronic transplant nephropathy) Neoplasia (eg, myeloma, leukemia, amyloidosis) Atherosclerotic kidney disease (ischemic) - Underlying atherosclerotic disease, dyslipidemia, and smoking are conditions commonly associated with cholesterol microembolism; catheter manipulations above the level of the renal arteries or anticoagulation in a patient with atherosclerosis can trigger cholesterol microembolic disease Metabolic diseases (eg, hypercalcemia, cystinosis, potassium depletion, hyperoxaluria) Genetics (eg, Alport syndrome, medullary cystic disease) Miscellaneous (eg, Balkan endemic nephropathy, Chinese herb/aristolochic acid nephropathy) [ 5 , 6 ] Lead nephropathy Environmental and occupational exposure to lead can cause chronic tubulointerstitial nephritis.

Occupations in welding, smelting, the battery industry, and mining have all been responsible for lead nephropathy cases. Environmental exposure from leaded gasoline is decreasing, because the use of leaded gasoline has ceased in the United States; however, sporadic exposure is still observed, particularly among children living in deteriorating housing in urban areas. Rarely, lead poisoning can be observed among individuals who consume moonshine whiskey and those who drink beverages from imported ceramics painted with leaded glaze. Obstructive uropathy A variety of causes contribute to obstructive uropathy, including prostate disease in elderly males; pelvic or colonic tumors involving both ureters in both sexes; nephrolithiasis, with or without urinary tract infection; and radiation to the pelvic area as well as some drugs, such as methysergide, can cause retroperitoneal fibrosis and obstruction.

Sjögren syndrome A study by Maripuri et al found that of 24 patients with primary Sjögren syndrome who also had renal impairment, biopsies revealed that 17 individuals had tubulointerstitial nephritis as the primary lesion behind their kidney dysfunction, [ 7 ] and 11 of the 17 patients had the chronic form of this nephritis. The investigators suggested these results support the notion that in patients with primary Sjögren syndrome, chronic tubulointerstitial nephritis is the most frequent cause of renal impairment found through kidney biopsy. Balkan endemic nephropathy Epidemiology and natural history clearly implicate environmental factors in the pathophysiology of Balkan endemic nephropathy. Lead contamination of food has been considered but ruled out as a cause of this disease. Some studies have implicated a fungal toxin, called "ochratoxin," which can grow in moist grains in storage and which has been shown to cause a similar kidney disease in pigs in several central European countries. However, most experts agree that the evidence for its role in this endemic nephropathy is weak.

More recent studies have linked aristolochic acid, the underlying factor in chinese herb nephropathy (see below), as a causative agent. [ 8 ] Chinese herb/aristolochic acid nephropathy In the early 1990s, aristolochic acid was recognized as a potent nephrotoxin that can cause rapidly progressive interstitial fibrosis and end-stage renal disease (ESRD) in young women using a Chinese herb as part of a slimming regimen in Belgium. Since then, many other cases of so-called Chinese herb (CH) nephropathy have been reported from around the world. Chinese herb nephropathy may not be an appropriate name for the disease, however, because aristolochic acid can be present in herbal medicines from any country. The term aristolochic acid nephropathy (AAN) more accurately characterizes this form of toxic nephropathy. Another interesting feature of term aristolochic acid nephropathy is its association with uroepithelial cancers reminiscent of Balkan nephropathy.

Aristolochic acid not only can trigger severe renal fibrosis, but it also can cause oncogene mutations that can explain the high incidence of renal cancer with this type of interstitial nephritis. Patients have also been found to have abnormal function of TP53, a known tumor suppressor gene. [ 5 ] A recently recognized cause of interstitial kidney disease is immunoglobulin G (IgG)-4–related disease. This multiorgan disorder, characterized by high serum levels of IgG and IgG4, is associated with a tubulointerstitial nephritis with an abundant IgG4-positive plasma cell interstitial infiltration and has a good response to steroids. [ 9 ] Previous Next: Epidemiology Primary tubulointerstitial diseases (ie, diseases of the renal tubules and interstitium sparing the glomeruli) constitute 10-15% of all kidney diseases both in the United States and around the world. In certain regions, such as the Balkans (ie, Yugoslavia, Bosnia, Croatia, Romania, Bulgaria), where endemic nephropathy is common, interstitial diseases may be more prevalent.

[ 5 , 6 ] Neither acute nor chronic tubulointerstitial diseases of the kidney demonstrate racial predilections. However, lead nephropathy may be more common in black people because of socioeconomic factors. Analgesic nephropathy is 5-6 times more common in women. This is generally attributed to women taking more analgesics than men. However, a greater sensitivity to the toxic effects of analgesics or differences in analgesic metabolism in women cannot be ruled out. All toxic nephropathies are related to the cumulative effects of toxic substances, particularly lead, and consequently are likely to be observed more frequently with advancing age. However, this is highly variable. For example, people with severe lead poisoning during childhood may present with chronic tubulointerstitial nephritis in early adult life. Atherosclerotic and/or ischemic kidney disease is increasingly more common in elderly individuals. Metabolic disorders, such as cystinosis, oxalosis, and hypercalcemia, can occur in younger individuals. Previous Next: Prognosis Tubulointerstitial disease may progress to end-stage renal disease (ESRD) and thus require dialysis or transplantation.

Electrolyte and acid-base disorders may also be observed, and an increased incidence of uroepithelial cancers is found among patients with analgesic nephropathy, aristolochic acid nephropathy, and Balkan endemic nephropathy. [ 5 , 6 ] Hypertension may also complicate any renal disease, but not all cases of interstitial renal disease are associated with hypertension (ie, Balkan endemic nephropathy, acute allergic interstitial nephritides). Most patients with allergic interstitial nephritis recover renal function upon cessation of the offending agent. Patients with cholesterol microembolic kidney disease often have some spontaneous improvement in renal function after the embolic event. Complete resolution of renal insufficiency is rare, however. Although the natural history of chronic tubulointerstitial nephritides varies depending on the etiology, most chronic tubulointerstitial renal disease eventually progresses to ESRD. However, the rate of progression is generally believed to be much slower in tubulointerstitial nephritis compared to glomerular diseases.

Previous Contributor Information and Disclosures Author A Brent Alper, Jr, MD, MPH Associate Professor of Medicine, Section of Nephrology and Hypertension, Department of Medicine, Tulane University School of Medicine Disclosure: Nothing to disclose. Specialty Editor Board Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Received salary from Medscape for employment. for: Medscape. Ajay K Singh, MB, MRCP, MBA Associate Professor of Medicine, Harvard Medical School; Director of Dialysis, Renal Division, Brigham and Women's Hospital; Director, Brigham/Falkner Dialysis Unit, Faulkner Hospital Disclosure: Nothing to disclose. Chief Editor Vecihi Batuman, MD, FASN Huberwald Professor of Medicine, Section of Nephrology-Hypertension, Tulane University School of Medicine; Chief, Renal Section, Southeast Louisiana Veterans Health Care System Disclosure: Nothing to disclose. Additional Contributors F John Gennari, MD Associate Chair for Academic Affairs, Robert F and Genevieve B Patrick Professor, Department of Medicine, University of Vermont College of Medicine

Question: What part of the body does interstitial nephritis affect?
Answer: Kidneys