What is nephritis?

Nephritis refers to inflammation of one or both kidneys. It can be caused by infection but is most commonly caused by autoimmune disorders that affect the major organs. For example, those with lupus are at a much higher risk for developing nephritis. In rare cases, nephritis can be genetically inherited, though it may not present in childhood. As the kidneys inflame, they begin to excrete needed protein from the body into the urine stream. This condition is called proteinuria. Loss of necessary protein due to nephritis can result in several life-threatening symptoms. Most dangerous in cases of nephritis is the loss of protein that keeps blood from clotting. This can result in blood clots causing a sudden stroke.

Nephritis causes additional problems like water retention, as the kidneys cannot function properly to rid the body of water. Water retention or edema, can further cause swelling of the feet, ankles, legs, and hands. This secondary symptom is usually treated with diuretics, which can help reduce the swelling and pain associated with edema.

How do you treat nephritis?

Primarily, nephritis tends to be treated with antibiotics and also occasionally with steroids, particularly in those cases thought to be caused by lupus. Nephritis is incurable when associated with lupus, but it can go into remission. Roughly half the cases associated with lupus, and with the inherited form of nephritis go into remission.

When nephritis is caused by infection, it is treated aggressively with antibiotics. Antibiotic treatment may have to be intravenous for several weeks if the infection has been present for a long time, and if the infection is particularly severe. This usually requires hospitalization.

How is nephritis diagnosed?

Nephritis is diagnosed by evaluating a patient’s history and possible family history for nephritis. When these do not exist, recent history of strep throat or bladder infection can indicate infectious nephritis. Those who have lupus are usually told they are predisposed to nephritis and are urged to report signs of swelling in the extremities to their doctors as soon as possible. Additionally pain in the kidneys, on either side of the lower back, may indicate nephritis.

Physicians may also order lab tests since urine analysis can be a significant help in diagnosing excess protein in the urine stream, as well as the presence of infection. Blood tests may also help diagnose nephritis. A physical exam can reveal kidneys that are swollen, and in some cases, magnetic resonance imaging (MRI) is used to evaluate the amount of swelling.

Infectious nephritis is easier to prevent if a patient with strep throat or bladder infection is diagnosed early and takes the appropriate antibiotics. You can reduce the chance of getting nephritis from urinary tract or bladder infections with a few simple behavioral changes. These include maintaining good hygiene when using the bathroom, like wiping front to back, drinking plenty of fluids, and urinating every couple of hours to clear the bladder.

Genetic and lupus induced nephritis are not preventable. However, those with lupus are more predisposed to develop infectious nephritis as well and can observe the above precautions to help reduce risk.