TION THERAPYafter surgery. The doctor may recom-
mend dietary changes and other lifestyle modifica-
tions, depending on the person’s general health
status. A single kidney provides more than ade-
quate function for people who are otherwise in rea-
sonably good health. Lifestyle factors such as
nutritious EATING HABITS, daily physical exercise, and
maintaining healthy weight reduce strain on the
kidney as well as the risk for HYPERTENSION(high
blood pressure) and DIABETES, the two health condi-
tions that are most likely to cause kidney disease.
See alsoMINIMALLY INVASIVE SURGERY; POSTOPERA-
TIVE PROCEDURES; PREOPERATIVE PROCEDURES; SURGERY
BENEFIT AND RISK ASSESSMENT.
nephritis INFLAMMATIONof the kidney. The most
common causes of nephritis are bacterial
INFECTION, which generally cause acute (sudden
onset) nephritis, and AUTOIMMUNE DISORDERS, which
tend to cause chronic or recurrent inflammation.
Nephritis can be acute (come on suddenly),
chronic (long-term), or recurrent (repeated
episodes of acute nephritis). Chronic nephritis can
lead to NEPHROPATHY.
Bacterial nephritis When infection involves
the glomeruli, it is infectious GLOMERULONEPHRITIS.
Infectious glomerulonephritis develops as a com-
plication of untreated or undertreated STREP THROAT
or other streptococcal infection elsewhere in the
body. Occasionally another bacterial strain such as
staphylococcus is responsible. Infection that trav-
els up the ureters from the BLADDERas a complica-
tion of untreated or undertreated URINARY TRACT
INFECTION(UTI) is pyelonephritis. In pyelonephritis
the infection involves the pelvis of the kidney
where URINE drains from the kidney into the
ureters. VESICOURETERAL REFLUX, in which urine
backflows from the bladder through the ureters to
the kidneys, is a common cause of pyelonephritis.
Interstitial nephritis In interstitial nephritis
the inflammation affects the spaces between the
tubules in the nephrons. Such inflammation is
nearly always a consequence of acute toxic
nephropathy. Medications such as penicillin and
penicillin-derived antibiotics, the diuretic medica-
tion furosemide and thiazide diuretics, and NON-
STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) are
commonly responsible for acute interstitial
nephritis. The nephritis generally resolves without
lingering complications within a few weeks of
stopping the medication.
Lupus nephritisThe autoimmune disorder SYS-
TEMIC LUPUS ERYTHEMATOSUS(SLE) affects the KIDNEYS
in about 40 percent of people who have SLE. In
some people, lupus nephritis may be the only man-
ifestation of SLE. Lupus nephritis can progress rap-
idly to RENAL FAILUREand END-STAGE RENAL DISEASE
(ESRD). Because women who have SLE outnumber
men who have SLE nearly nine to one, lupus
nephritis far more commonly affects women.
Hereditary nephritis Hereditary nephritis is a
genetic disorder that results from GENEmutations.
The symptoms of hereditary nephritis are appar-
ent at or shortly after birth, and the inflammation
tends to be progressive. The most frequent presen-
tation of hereditary nephritis is ALPORT’S SYNDROME,
a disorder of protein encoding.Symptoms and Diagnostic Path
The symptoms of nephritis may include- HEMATURIA(bloody urine)
- OLIGURIA(diminished urine volume)
- edema (fluid retention that causes swelling in
the tissues), notably of the face, hands and
arms, and legs and feet - loss of APPETITE, NAUSEA, and VOMITING
- FEVER(bacterial nephritis)
The diagnostic path begins with urinalysis and
BLOODtests that assess kidney function. Urinalysis
may show the presence of BACTERIA, indicating the
cause of the nephritis is infection. Other diagnostic
procedures the nephrologist may choose to con-
duct include further blood and urine tests, ULTRA-
SOUND, COMPUTED TOMOGRAPHY (CT) SCAN, and
kidney biopsy. The biopsy shows the presence of
inflammation and any damage that has occurred
to the tubules or glomeruli.Treatment Options and Outlook
Treatment depends on the underlying cause. Bac-
terial nephritis requires antibiotic therapy, often
long term (up to six months). Severe infection
requires hospitalization for intravenous ANTIBIOTIC
MEDICATIONS. Most people recover fully and with-
out residual damage from bacterial nephritis.nephritis 207