interstitial nephritis

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nephritis

 [nĕ-fri´tis] (pl. nephri´tides)
inflammation of the kidney; a focal or diffuse proliferative or destructive disease that may involve the glomerulus, tubule, or interstitial renal tissue. Called also Bright's disease. The most usual form is glomerulonephritis, that is, inflammation of the glomeruli, which are clusters of renal capillaries. Damage to the membranes of the glomeruli results in impairment of the filtering process, so that blood and proteins such as albumin pass out into the urine. Depending on the symptoms it produces, nephritis is classified as acute nephritis, chronic nephritis, or nephrosis (called also the nephrotic syndrome).
Acute Nephritis. This occurs most frequently in children and young people and seems to strike those who have recently suffered from sore throat, scarlet fever, and other infections caused by streptococci; it is believed to originate as an immune response on the part of the kidney. An attack may produce no symptoms, but more often there are headaches, a rundown feeling, back pain, and perhaps slight fever. The urine may look smoky, bloody, or wine-colored. Analysis of the urine shows the presence of erythrocytes, albumin, and casts. Another symptom is edema of the face or ankles, more common in the morning than in the evening. The blood pressure usually rises during acute nephritis, and in severe cases hypertension may be accompanied by convulsions.

Treatment consists chiefly of bed rest and a carefully controlled diet. Penicillin is often used if an earlier streptococcal infection is still lingering. Recovery is usually complete. In a small percentage of cases, however, acute nephritis resists complete cure. It may subside for a time and then become active again, or it may develop into chronic nephritis. Dialysis may be indicated in patients with fluid overload that is refractory to diuretics, or who become clinically uremic.
Chronic Nephritis. Chronic nephritis may follow a case of acute nephritis immediately or it may develop after a long interval during which no symptoms have been present. Many cases of chronic nephritis occur in people who have never had the acute form of the disease. Symptoms are often unpredictable and variable from case to case, but there is almost always steady, progressive, permanent damage to the kidneys.

Chronic nephritis generally moves through three stages. In the first stage, the latent stage, there are few outward symptoms. There may be slight malaise, but often the only indication of the disease is the presence of albumin and other abnormal substances in the urine. If a blood count is made during this stage, anemia may be found. There is no special treatment during the latent stage of chronic nephritis. The patient can live a normal life but should avoid extremes of fatigue and exposure and should eat a well balanced diet.

The first stage may be followed by a second stage, in which edema occurs in the face, legs, or arms. The main treatment in this stage consists of a low-protein, low-sodium diet and diuretics. Steroid hormones may be helpful.

At the final stage of chronic nephritis is end-stage renal disease. Treatments are kidney transplant and dialysis. At any stage of chronic nephritis it is particularly important to avoid other infections, which will aggravate the condition.

There is no known cure for chronic nephritis, although the progress of the disease can be delayed, so that the patient can live an almost normal life for years. Many patients are being helped by repeated purification of their uremic blood by hemodialysis or peritoneal dialysis, or by transplantation.
glomerular nephritis glomerulonephritis.
interstitial nephritis nephritis with increase of interstitial tissue and thickening of vessel walls and malpighian corpuscles; it may be due to overuse of analgesics, mercury poisoning, gout, or any of various other conditions.
lupus nephritis glomerulonephritis associated with systemic lupus erythematosus.
potassium-losing nephritis see under nephropathy.
radiation nephritis kidney damage caused by ionizing radiation; symptoms include glomerular and tubular damage, hypertension, and proteinuria, sometimes leading to renal failure. It may be acute or chronic, and some varieties do not manifest until years after the radiation exposure.
salt-losing nephritis salt-losing nephropathy.
transfusion nephritis nephropathy following transfusion from an incompatible donor as a result of the hemoglobin of the hemolyzed red blood cells being deposited in the renal tubules.
tubulointerstitial nephritis nephritis of the renal tubules and interstitial tissues, usually seen secondary to a drug sensitization, systemic infection, graft rejection, or autoimmune disease. Characteristics include lymphocytes in interstitial infiltrate and within tubules, mild hematuria, and pyuria. Acute tubulointerstitial nephritis is usually seen as a complication of infection or allergy. Chronic tubulointerstitial nephritis is when the condition has progressed to interstitial fibrosis with shrunken kidneys, a lowered glomerular filtration rate, and danger of renal failure.

in·ter·sti·tial ne·phri·tis

a form of nephritis in which the interstitial connective tissue is chiefly affected.

interstitial nephritis

inflammation of the interstitial tissue of the kidney, including the tubules. The condition may be acute or chronic. Acute interstitial nephritis is an immunological adverse reaction to certain drugs, often sulfonamide or methicillin (allergic interstitial nephritis). Acute renal failure, fever, rash, and proteinuria are characteristic of this condition. Most people regain normal kidney function when the offending drug is discontinued. Chronic interstitial nephritis is a syndrome of interstitial inflammation and structural changes, sometimes associated with such conditions as ureteral obstruction, pyelonephritis, exposure of the kidney to a toxin, rejection of a transplant, and certain systemic diseases. Gradually renal failure, nausea, vomiting, weight loss, fatigue, and anemia develop. Acidosis and hyperkalemia may follow. The nurse watches carefully for signs of electrolyte imbalance, dehydration, and hypovolemia, especially if there is frequent vomiting. Fluids and electrolytes may be replaced intravenously. Treatment includes correction of the underlying cause. If the cause is an obstruction of the urinary tract, rapid recovery may follow removal of the obstruction. In other cases, hemodialysis and kidney transplantation may be necessary.

Interstitial nephritis

Tubulointerstitial nephritis Nephrology Inflammation of the space in and around the renal tubules; IN may be a transient drug response or chronic and progressive; it may accompany analgesic nephropathy and acute interstitial allergic nephritis Drugs linked to IN Antibiotics–penicillin, ampicillin, methicillin, sulfonamides, etc; NSAIDs, furosemide, thiazide diuretics Clinical IN ↓ renal function–from mild dysfunction to acute renal failure–ARF; ±1⁄2 of cases exhibit ↓ urine output and other signs of ARF–eg, failure to concentrate urine or regulate acid/base levels–resulting in metabolic acidosis, progression to ESRD. See Renal failure.

in·ter·sti·tial ne·phri·tis

(in'tĕr-stish'ăl nĕ-frī'tis)
A form of nephritis in which the interstitial connective tissue is chiefly affected.

interstitial

pertaining to or situated between parts or in the interspaces of a tissue.

atypical interstitial pneumonia
interstitial cell adenoma
see interstitial cell tumor (below).
interstitial cell-stimulating hormone
luteinizing hormone.
interstitial cell
the cells of the connective tissue of the ovary or the testis (Leydig's cells), which furnish the internal secretion of those structures.
interstitial cell tumor
a common testicular tumor in old dogs. Most are benign and not associated with any major clinical disturbances but there may be concurrent perianal gland neoplasms, infertility and rarely feminization or viciousness. Called also Leydig cell tumor or interstitial cell adenoma.
interstitial edema
edema of the interstitial interlobular tissue in the lung.
interstitial emphysema
pulmonary emphysema with air accumulated in the interlobular connective tissue; characteristic of emphysema in cattle.
interstitial fluid
the extracellular fluid bathing cells in most tissues, excluding the fluid within the lymph and blood vessels.
interstitial gland
of the ovary, consisting of polyhedral epithelioid cells in the stroma of the ovary and have characteristics of cells which produce steroids.
interstitial nephritis
interstitial fluid pressure
pressure exerted by the free interstitial fluid; if the pressure is negative this tends to suck fluid out of the vascular system and into the tissue space; if the pressure is greater than the intravascular pressure fluid tends to move out of the tissue space.
interstitial pneumonia
interstitial space
tissue space.
interstitial tissue
connective tissue between the cellular elements of a structure.

nephritis

inflammation of the kidney; a focal or diffuse proliferative or destructive disease that may involve the glomerulus, tubule or interstitial renal tissue. See also glomerulonephritis, interstitial nephritis (below), nephrosis, pyelonephritis.

autoimmune nephritis
embolic nephritis
caused by infected emboli lodging in renal vessels. One or more abscesses may develop, causing signs referable to toxemia. There may be intermittent pyuria. Renal dysfunction is likely only if most of the renal mass is destroyed.
glomerular nephritis
interstitial nephritis
a diffuse lesion characterized by interstitial inflammation and fibrosis, sometimes attributed to hematogenous infection with Leptospira spp. There is a secondary glomerular and vascular injury. It is manifested by polyuria, urine of low specific gravity, and terminal uremia.
lupus nephritis
glomerulonephritis associated with systemic lupus erythematosus.
parenchymatous nephritis
nephritis affecting the parenchyma of the kidney.
suppurative nephritis
a form accompanied by suppuration and abscessation of the kidney.
transfusion nephritis
nephropathy following transfusion from an incompatible donor.
References in periodicals archive ?
The main autopsy findings included myocarditis, interstitial nephritis, interstitial pneumonitis, encephalitis, and generalized lymphadenitis.
Mycoplasma pneumoniae has been linked to renal diseases such as mesangiocapillary glomerulonephritis type II, acute glomerulonephritis IgA nephritis, interstitial nephritis, and asymptomatic glomerulonephritis.