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nephritis[nĕ-fri´tis] (pl. nephri´tides)
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 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.
tu·bu·lo·in·ter·sti·tial ne·phri·tis(tū'byū-lō-in-tĕr-stish'ăl nĕ-frī'tis)
nephritis(ne-frit'is) (ne-frit'i-dez?) plural.nephritides [ nephr- + -itis]
Renal function is assessed by measuring serum creatinine, blood urea nitrogen, and urine creatinine clearance levels. Signs of renal failure (oliguria, azotemia, acidosis) are reported. Hemoglobin, hematocrit, electrolyte levels, intake and output of fluids, and body weights are monitored. The health care provider observes, records, and reports hematuria and monitors blood pressure using the same cuff, arm, and position each time. Antihypertensive drugs are administered as prescribed. The patient is encouraged to maintain adequate hydration and follow the prescribed dietary restrictions, which may include limits on the amounts of sodium, potassium, fluid volume, and protein ingested. Intravenous fluid intake is monitored. Complications of hypertension are anticipated and prevented.