Editing Nephritis

{{Short description|Inflammation of the kidneys}}
{{Distinguish|nephrosis}}
{{Infobox medical condition (new)
| name            = Nephritis
| synonyms        =
| image           = File:Hunter enlarged kidney.jpg
| caption         = Enlarged kidney (anatomy)
| pronounce       =
| field           = [[Nephrology]]
| symptoms        =
| complications   =
| onset           =
| duration        =
| types           = Glomerulonephritis<ref name=nih2/> and Interstitial nephritis<ref name=nih1/>
| causes          =
| risks           =
| diagnosis       = Ultrasound, X-ray<ref name=guide/>
| differential    =
| prevention      =
| treatment       = Depends on type(See type)
| medication      =
| prognosis       =
| frequency       =
| deaths          =
}}

'''Nephritis''' is [[inflammation]] of the [[kidneys]] and may involve the [[Glomerulus (kidney)|glomeruli]], [[Mesonephric tubule|tubules]], or [[medullary interstitium|interstitial tissue]] surrounding the glomeruli and tubules.<ref>Keto Acids – Advances in Research and Application 2013 Edition p.220e</ref> It is one of several different types of [[nephropathy]].

==Types==
* [[Glomerulonephritis]] is inflammation of the [[Glomerulus (kidney)|glomeruli]]. Glomerulonephritis is often implied when using the term "nephritis" without qualification.<ref name="nih2">{{Cite web|title = Glomerulonephritis: MedlinePlus Medical Encyclopedia|url = https://www.nlm.nih.gov/medlineplus/ency/article/000484.htm|website = www.nlm.nih.gov|access-date = 2015-06-14}}</ref>
* [[Interstitial nephritis]] (or tubulo-interstitial nephritis) is inflammation of the spaces between [[renal tubule]]s.<ref name="nih1">{{Cite web|title = Interstitial nephritis: MedlinePlus Medical Encyclopedia|url = https://www.nlm.nih.gov/medlineplus/ency/article/000464.htm|website = www.nlm.nih.gov|access-date = 2015-06-14}}</ref>

==Causes==
Nephritis can often be caused by infections and toxins, but it is most commonly caused by [[autoimmune disorder]]s that affect the major organs like kidneys.<ref>{{cite web|title=Acute Nephritis; Nephrosis; Nephritic syndrome information. Patient {{!}} Patient|url=http://patient.info/doctor/acute-nephritis|website=Patient|access-date=23 July 2016}}</ref>
* [[Pyelonephritis]] is inflammation that results from a [[urinary tract infection]] that reaches the [[renal pelvis]] of the kidney.<ref>{{Cite web|title = Pyelonephritis: Kidney Infection|url = http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/pyelonephritis-kidney-infection/Pages/index.aspx|website = www.niddk.nih.gov|access-date = 2015-06-14}}</ref>
* [[Lupus nephritis]] is inflammation of the kidney caused by [[systemic lupus erythematosus]] (SLE), a disease of the [[immune system]].<ref>{{Cite web|title = Lupus Nephritis|url = http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/lupus-nephritis/Pages/index.aspx|website = www.niddk.nih.gov|access-date = 2015-06-14|archive-date = 2017-01-04|archive-url = https://web.archive.org/web/20170104195333/https://www.niddk.nih.gov/health-information/health-topics/kidney-disease/lupus-nephritis/Pages/index.aspx|url-status = dead}}</ref>
* Athletic nephritis is nephritis resulting from strenuous exercise.<ref name="esagil">{{cite web|title=Nephritis Symptoms|url=http://esagil.org/Nephritis-Description.aspx|website=esagil.org}}</ref> Bloody urine after strenuous exercise may also result from [[march hemoglobinuria]], which is caused by trauma to [[red blood cell]]s, causing [[hemolysis|their rupture]], which leads to the release of hemoglobin into the urine.<ref>{{cite book |last1=Shinton |first1=N. K. |url=https://books.google.com/books?id=b0aw2SLzZQ8C&q=%22Mechanical+hemolytic+anemia%22&pg=PA591 |title=Desk Reference for Hematology |publisher=CRC Press |year=2007 |isbn=9781420005127 |access-date=2019-02-14 }}</ref>

==Mechanism==
[[File:Renin-angiotensin system in man shadow.svg|150 px|thumb|Renin–angiotensin system]]
Nephritis can produce glomerular injury, by disturbing the glomerular structure with inflammatory cell proliferation.<ref>{{Cite web|title = Glomerular Diseases|url = http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/glomerular-diseases/Pages/facts.aspx|website = www.niddk.nih.gov|access-date = 2015-06-15}}</ref> This can lead to reduced glomerular blood flow, leading to reduced urine output ([[oliguria]])<ref>{{cite web|title=Oliguria: Background, Etiology, Epidemiology|url=http://emedicine.medscape.com/article/983156-overview|website=Medscape|publisher=eMedicine|access-date=23 July 2016}}</ref> and retention of waste products ([[uremia]]).<ref>{{Cite web|title = uremia {{!}} accumulation in the blood of constituents normally eliminated in the urine that produces a severe toxic condition and usually occurs in severe kidney disease|url = http://www.merriam-webster.com/medical/uremia|website = www.merriam-webster.com|access-date = 2015-06-14}}</ref> As a result, red blood cells may leak out of damaged glomeruli, causing blood to appear in the urine ([[hematuria]]).<ref>{{Cite web|title = Hematuria (Blood in the Urine)|url = http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/hematuria-blood-in-the-urine/Pages/facts.aspx|website = www.niddk.nih.gov|access-date = 2015-06-14}}</ref>

Low renal blood flow activates the [[renin–angiotensin system|renin–angiotensin–aldosterone system]] (RAAS), causing fluid retention and mild [[hypertension]].<ref>{{Cite book|title = Johns Hopkins Internal Medicine Board Review: Certification and Recertification|url = https://books.google.com/books?id=m3iwi7Wix8kC&pg=PA51 |publisher = Elsevier Health Sciences|date = 2012-02-20|isbn = 978-0323087988|language = en|first1 = Bimal|last1 = Ashar|first2 = Redonda|last2 = Miller|first3 = Stephen|last3 = Sisson|first4 = Johns Hopkins|last4 = Hospital}}</ref> As the kidneys inflame, they begin to excrete needed protein from the affected individual's body into the urine stream. This condition is called [[proteinuria]].<ref>{{Cite web|title = Proteinuria|url = http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/proteinuria/Pages/facts.aspx|website = www.niddk.nih.gov|access-date = 2015-06-14}}</ref>

Loss of necessary protein due to nephritis can result in several life-threatening symptoms. The most serious complication of nephritis can occur if there is significant loss of the proteins that keep blood from clotting excessively. Loss of these proteins can result in blood clots, causing sudden stroke.<ref>{{Cite book|title = The Lupus Encyclopedia: A Comprehensive Guide for Patients and Families|url = https://books.google.com/books?id=8V2RAwAAQBAJ&pg=PA205 |publisher = JHU Press|date = 2014-05-22|isbn = 9781421409849|language = en|first = Donald E. Jr|last = Thomas}}</ref>

==Diagnosis==
The diagnosis depends on the cause of the nephritis, and in the case of [[lupus nephritis]], [[blood tests]], X-rays and an ultrasound can help ascertain if the individual has the condition.<ref name="guide">{{cite web|title=American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis. {{!}} National Guideline Clearinghouse|url=https://www.guideline.gov/summaries/summary/36900?|website=www.guideline.gov|access-date=23 July 2016|archive-url=https://web.archive.org/web/20160915235645/https://www.guideline.gov/summaries/summary/36900|archive-date=15 September 2016|url-status=dead|df=dmy-all}}</ref>

==Treatment==
[[File:Nephritis and nephrosis world map - DALY - WHO2004.svg|right|thumb|150 px|upright=1.75|[[Disease burden]] of nephritis/[[nephrosis]] worldwide in 2004.<ref>{{cite web |url=https://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html |title=WHO Disease and injury country estimates |year=2009 |work=World Health Organization |access-date=Nov 11, 2009}}</ref>
{{Div col|small=yes|colwidth=10em}}
{{legend|#b3b3b3|no data}}
{{legend|#ffff65|less than 40}}
{{legend|#fff200|40–120}}
{{legend|#ffdc00|120–200}}
{{legend|#ffc600|200–280}}
{{legend|#ffb000|280–360}}
{{legend|#ff9a00|360–440}}
{{legend|#ff8400|440–520}}
{{legend|#ff6e00|520–600}}
{{legend|#ff5800|600–680}}
{{legend|#ff4200|680–760}}
{{div col end}}]]
Treatment (or management) of nephritis depends on what has provoked the inflammation of the kidney(s). In the case of lupus nephritis, [[hydroxychloroquine]] could be used.<ref>{{cite web|title=Hydroxychloroquine: MedlinePlus Drug Information|url=https://medlineplus.gov/druginfo/meds/a601240.html|website=medlineplus.gov|access-date=23 July 2016}}</ref>

===Prevalence===
Nephritis represents the ninth-most-common cause of death among all women in the US (and the fifth leading cause among non-[[Hispanic]] black women).<ref>{{Cite web|title = Leading Causes of Death - Women's Health USA 2010|url = http://mchb.hrsa.gov/whusa10/hstat/hi/pages/208lcd.html|website = mchb.hrsa.gov|access-date = 2015-06-14}}</ref>

Worldwide, the highest rates{{clarify|date=June 2015}} of nephritis are 50–55% for African or Asian descent followed by Hispanic at 43% and [[White people|Caucasian]] at 17%.<ref>{{Cite book|title = Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation|url = https://books.google.com/books?id=buSjLdvrwXYC&pg=PA562 |publisher = Springer Science & Business Media|date = 2012-10-28|isbn = 9781461444541|language = en|first1 = Edgar|last1 = Lerma|first2 = Mitchell|last2 = Rosner}}</ref>

The average age of an individual diagnosed with kidney inflammation (in this case, lupus nephritis) is 28.4 years old.<ref>{{Cite |date=2018-04-22|title=Lupus Nephritis: Practice Essentials, Background, Pathophysiology|url=https://emedicine.medscape.com/article/330369-overview#showall}}</ref>

==See also==
* [[Nephrotic syndrome]]
* [[Bright's disease]]
* [[Goodpasture syndrome]]

==References==
{{Reflist}}

== External links ==
{{Medical resources
| DiseasesDB      =
| ICD10           =
| ICD9            =
| ICDO            =
| OMIM            =
| MedlinePlus     =
| eMedicineSubj   =
| eMedicineTopic  =
| MeshID          = D009393
| SNOMED CT       = 52845002
}}
{{Commons}}	

{{Scholia|topic}}
{{Nephrology}}
{{Authority control}}

[[Category:Inflammations]]
[[Category:Kidney diseases]]