ACUTE NEPHRITIS

Acute nephritis occurs when the kidneys suddenly become inflamed. Acute nephritis has several causes,
and it can ultimately lead to kidney failure if it’s left untreated. This condition used to be known as
Bright's disease.

Types of acute nephritis

There are several types of acute nephritis:

Interstitial nephritis

In interstitial nephritis, the spaces between the kidney tubules become inflamed. This inflammation
causes the kidneys to swell.

Pyelonephritis

Pyelonephritis is an inflammation of the kidney, usually due to a bacterial infection. In the majority of
cases, the infection starts within the bladder and then migrates up the ureters and into the kidneys. Ureters
are two tubes that transport urine from each kidney to the bladder.

Glomerulonephritis

This type of acute nephritis produces inflammation in the glomeruli. There are millions of capillaries
within each kidney. Glomeruli are the tiny clusters of capillaries that transport blood and behave as
filtering units. Damaged and inflamed glomeruli may not filter the blood properly.

Causes of acute nephritis

Interstitial nephritis

This type often results from an allergic reaction to a medication or antibiotic. An allergic reaction is the
body’s immediate response to a foreign substance. The doctor may have prescribed the medicine to help
them, but the body views it as a harmful substance. This makes the body attack itself, resulting in
inflammation.

Low potassium in the blood is another cause of interstitial nephritis. Potassium helps regulate many
functions in the body, including heartbeat and metabolism.

Taking medications for long periods of time may damage the tissues of the kidneys and lead to interstitial
nephritis.

Pyelonephritis

The majority of pyelonephritis cases results from E.coli bacterial infections. This type of bacterium is
primarily found in the large intestine and is excreted in the stool. The bacteria can travel up from the
urethra to the bladder and kidneys, resulting in pyelonephritis.

Although bacterial infection is the leading cause of pyelonephritis, other possible causes include:

 urinary examinations that use a cystoscope, an instrument that looks inside the bladder

 surgery of the bladder, kidneys, or ureters

 the formation of kidney stones, rocklike formations consisting of minerals and other waste material

Glomerulonephritis

The main cause of this type of kidney infection is unknown. However, some conditions may encourage an
infection, including:

 problems in the immune system

 a history of cancer

 an abscess that breaks and travels to the kidneys through the blood

Risk factors of acute nephritis

 a family history of kidney disease and infection

 having an immune system disease, such as lupus

 taking too many antibiotics or pain medications

 recent surgery of the urinary tract

Symptoms of acute nephritis

 pain in the pelvis

 pain or a burning sensation while urinating

 a frequent need to urinate

 cloudy urine

 blood or pus in the urine

 pain in the kidney area or abdomen

 swelling of the body, commonly in the face, legs, and feet

 vomiting

 fever

 high blood pressure

Diagnosis of acute nephritis

A doctor will perform a physical exam and take a medical history to determine if they could be at an
increased risk for acute nephritis.

Lab tests can also confirm or rule out the presence of an infection. These tests include a urinalysis, which
tests for the presence of blood, bacteria, and white blood cells (WBCs). A significant presence of these
can indicate an infection.

A doctor may also order blood tests. Two important indicators are blood urea nitrogen (BUN)
and creatinine. These are waste products that circulate in the blood, and the kidneys are responsible for
filtering them. If there’s an increase in these numbers, this can indicate the kidneys aren’t working as
well.

An imaging scan, such as a CT scan or renal ultrasound, can show a blockage or inflammation of the
kidneys or urinary tract.

A renal biopsy is one of the best ways to diagnose acute nephritis. Because this involves testing an actual
tissue sample from the kidney, this test isn’t performed on everyone. This test is performed if a person
isn’t responding well to treatments, or if a doctor must definitively diagnose the condition.

Treatment of acute nephritis

Treatment for glomerulonephritis and interstitial nephritis may require treating the underlying conditions
causing the problems. For example, if a medication they’re taking is causing kidney problems, the doctor
may prescribe an alternate medication.

Medications

A doctor will typically prescribe antibiotics to treat the kidney infection. If the infection is very serious,
they may require intravenous (IV) antibiotics within the hospital inpatient setting. IV antibiotics tend to
work faster than antibiotics in pill form. Infections such as pyelonephritis can cause severe pain. The
doctor may prescribe medication to relieve pain as they recover.

If the kidneys are very inflamed, the doctor may prescribe corticosteroids.

Supplements

When the kidneys aren’t working as well, it can impact the balance of electrolytes in the body.
Electrolytes, such as potassium, sodium, and magnesium, are responsible for creating chemical reactions
in the body. If the electrolyte levels are too high, the doctor may prescribe IV fluids to encourage the
kidneys to release the extra electrolytes. If the electrolytes are low, they may need to take supplements.
These could include potassium or phosphorus pills. However, they shouldn’t take any supplements
without the doctor’s approval and recommendation.

Dialysis

If the kidney function is significantly impaired due to the infection, they may require dialysis. This is a
process in which a special machine acts like an artificial kidney. Dialysis may be a temporary necessity.
However, if the kidneys have experienced too much damage, they may need dialysis permanently.

Home care

When they have acute nephritis, the body needs time and energy to heal. The doctor will likely
recommend bed rest during the recovery. The doctor may also advise them to increase the fluid intake.
This helps to prevent dehydration and keep the kidneys filtering to release waste products.

If the condition affects the kidney function, the doctor may recommend a special diet low in certain
electrolytes, such as potassium. Many fruits and vegetables are high in potassium. The doctor may
instruct you regarding which foods are low in potassium.

They can also soak some vegetables in water and drain the water before cooking them. This process,
known as leaching, can remove extra potassium.

The doctor may also recommend cutting back on high-sodium foods. When they have too much sodium
in the blood, the kidneys hold onto water. This can increase the blood pressure.