Understanding Nephritis: Types, Causes, Symptoms & Treatment Options

What is Nephritis?

Nephritis refers to inflammation of the kidneys, which disrupts normal kidney function, causing protein leakage into urine, water retention, and potential kidney failure.It can involve different parts of the kidney, including the glomeruli (glomerulonephritis), tubules (tubulo-interstitial nephritis), or interstitial renal tissue (interstitial nephritis).

Kidney Anatomy and Functions

The kidneys are a pair of bean-shaped organs located under the ribs on both sides of the spine. These essential organs filter blood, remove waste, balance electrolytes, regulate blood pressure, and produce hormones that control red blood cell production. Each basic functional unit of the kidney contains millions of nephrons, which perform a two-step filtration process:- The glomerulus filters protein and blood cells while allowing electrolytes, toxins, waste and water to pass along its tubules. - The tubule reabsorbs essential substances and excretes the remaining waste as urine.

Urine then empty into the bladder through the ureters and passes out through the urethra. Kidneys process about 120 to 150 quarts of blood/day and remove up to 2 quarts of waste products and excess water. when the kidney is inflamed is termed as Nephritis, a general term used to describe a group of diseases that cause swelling or inflammation of the glomerulus in the kidneys

Nephritis is a serious kidney condition requiring early diagnosis and treatment to prevent long-term health issues. Maintaining a healthy lifestyle and seeking timely medical care can help manage and reduce the risk of nephritis.

Types of Nephritis

Nephritis can be classified into various types which are as follows:

Acute Glomerulonephritis

This is sudden inflammation of the kidneys that occurs after infections like strep throat or hepatitis. It can be cause by lupus and other rarest disorders such as granulomatosis with polyangiitis (GPA) and vasculitides. Patients’ needs prompt medical attention else it can lead to kidney damage.

Chronic Glomerulonephritis

This follows acute nephritis with gradual onset of few or unpredictable symptoms leading to severe kidney damage if symptoms are not well-diagnosed and the condition is left untreated. This type of nephritis is categorized into three stages, first, second and third stage with specific presenting symptoms. In chronic glomerulonephritis,there is always steady, progressive, permanent damage to the kidneys. The third or final stage is End-stage renal disease, which has no cure. Individuals may need purification of their uremic blood only by peritoneal or hemodialysis or kidney transplantation to live for some years.

Pyelonephritis

Kidney infection caused by the bacteria Escherichia Coli. It develops when urinary tract infections reach the kidneys renal pelvis causing inflammation.

Lupus Nephritis

This is an autoimmune-related kidney inflammation. The disease occurs when the immune system attacks the kidneys. It is mostly seen in Lupus patients. Specific symptoms of lupus nephritis includes fever, elevated blood pressure, joint issues, rashes among others. Symptoms can sometimes go into remission which can become serious. Hence, seeking prompt medical attention to reduce kidney damage is crucial.

IgA Nephropathy

This is a very common type of nephritis caused by IgA antibody deposits in the kidneys that causes inflammation. Individuals with this form of nephritis have defective IgA antibodies. Medications to control blood pressure is effective to treatment.

Interstitial Nephritis (tubulo-interstitial nephritis)

Rapid onset due to infections or certain medications. It mainly affects the fluid-filled space of the kidneys called the interstitium. Low amount of potassium in the blood also account for tubulo-interstitial nephritis. When the underlying medicine is discovered and weans off, patient fully gain recovery within a week.

Hereditary Nephritis (Alport Syndrome)

Genetic disorder affecting kidney function, hearing, and vision. It’s usually seen in men and its passed on from genes as by its name. it can lead to kidney failure if left untreated.

Risk factors for Nephritis

Several factors increase the likelihood of developing nephritis:

• Obesity
• Diabetesand hypertension
• Genetic predisposition
• Advanced age (60 and above)
• Chronic infections
• Immune system disorders

Causes of Nephritis

Nephritis can be caused several factors such as infections, toxins or poisons, however, it is often results from an autoimmune disease like lupus that attack the kidneys and other organs and tissues in the body.

• Autoimmune diseases (e.g., lupus, vasculitides)
• Bacterial or viral infections
• Prolonged use of certain medications
• Toxin exposure
• Severe allergic reactions
• Metabolic disorders
• High-intensity exercise (Athletic Nephritis)
• Pyelonephritis

Pathophysiology of Nephritis

Nephritis triggers an immune response that damages kidney tissues. Inflammatory mediators increase vascular permeability, leading to protein leakage, reduced filtration capacity, and water retention. Chronic inflammation results in fibrosis, scarring, and potential kidney failure.

Signs & Symptoms of Nephritis

Nephritis may present with:

• Cloudy, foamy, or dark-colored urine
• Pelvic or abdominal pain
• Frequent, painful urination
• Blood or pus in urine
• Swelling in the face, legs, and feet
• High blood pressure
• Headaches
• Drowsiness
• Fever, nausea, and vomiting
• Mental confusion and fatigue
• Weight gain from water retention
• Pain in the abdomen or kidney area
• Glomerulonephritis

Diagnostic Test & Investigations

• Urinalysis to checks for protein, blood, or bacteria in urine.
• Blood tests to measure blood urea nitrogen (BUN) and creatinine.
• Kidney biopsy to examines kidney tissue for inflammation.
• Imaging tests such as CT scans and renal ultrasonography to assess kidney structure and function.

Treatment of Nephritis

Treatment depends on the type and severity of nephritis. Reducing symptoms and treating the underlying cause to reduce kidney inflammations is the mainstay of treatment. Lifestyle modification and medications are the primary goal. In severe cases where kidney function is severely impaired, patients maybe introduce to dialysis for advance treatment.

Medications

• Anti-inflammatory drugs (e.g., corticosteroids)
• Blood pressure medications (e.g., ACE inhibitors, diuretics)
• Immunosuppressants for autoimmune conditions
• Antibiotics for bacterial infections
• Dietary Modifications
• Reducing salt, potassium, and protein intake
• Managing fluid consumption
• Dialysis or Kidney Transplant - Required in severe cases where kidney function is significantly impaired

Preventions of Nephritis

Preventing nephritis involves lifestyle adjustments:

• Maintain Good Hygiene – Proper wiping techniques reduce bacterial spread
• Stay Hydrated – Regular urination prevents bacterial growth
• Wear Loose-fitting Clothing – Prevents moisture buildup and bacterial growth
• Avoid Excessive Medication Use – Certain drugs can harm kidney tissue
• Manage Chronic Conditions – Control diabetes and hypertension to reduce kidney stress
• Regular Medical Checkups – Early detection can prevent severe complications