Tubulo-interstitial nephritis is a common kidney disease and canal lesions leading to impaired organ function. The disease is characterized by an extensive change in the structure of interstitial renal tissue. There are two types of the course of the disease - acute and chronic. In the instructions of many medications that enter the human body, it is mentioned that medications are excreted through the kidneys. The thoughtless and uncontrolled use of medications leads to illness due to allergies to certain medications or herbal therapy. The disease also occurs as a result of a previous infection.
To identify tubulointerstitial nephritis, methods of modern body research are used, namely: ultrasound, analysis of urine and blood, collection of medical history, kidney biopsy. The conclusion regarding the reversibility of the disease is made on the basis of the severity of the damage and the timing of seeking medical help.
Causes of the disease
Sometimes taking antibiotics or other anti-inflammatory drugs is prolonged for a long time. And kidney damage occurs after severe poisoning with chemicals, heavy metals. Ethanol vapors are particularly fatal. Tubulo-interstitial nephritis can occur due to many reasons:
- after a viral infection - in 46% of cases;
- toxic manifestations of an allergic nature provoke the disease in 28.3%;
- metabolic disorders in the body contribute to the onset of the disease in 13.9%;
- disorders of the circulatory function of the ureters - 8.8%;
- genetic and immune causes - in 0.9% of diseases;
- several reasons are immediately observed in 2.5% of cases.
Chronic forms of the disease are caused by serious violations of the integrity of the cytomembranes, renal tissue dysplasia, metabolic changes, congenital and acquired abnormalities of the ureters.
Establishing diagnosis
A number of studies of a physical and laboratory nature are being conducted. And only then an accurate diagnosis is made. Tubulo-interstitial nephritis is suspected in a patient with the occurrence of expressive symptoms, which are diagnosed by independent physical manifestations.
A chronic disease is the result of infiltration and atrophy of the channels in the human body for a long time. The function of the organ is suppressed gradually - over several years. The patient goes to the doctor when unpleasant symptoms appear, such as kidney pain, rash, and others. They give him significant discomfort. The disease affects two kidneys at once or damages only one.
In a laboratory study of urine, a urinary sediment with a high content of red blood cells and white blood cells is clearly visible. In this case, there is a complete absence of dysmorphic red blood cells and only a slight manifestation of hematuria. The presence of eosinophils in the urine does not characterize the presence of the disease, since only in 50% of cases they are a consequence of the disease. If they are not at all, then this indicates that the disease is absent. Proteinuria is detected by minimal indicators, but if glomerular pathology caused by the use of antibiotics has already developed in the body, then this indicator reaches a nephrotic level.
In a blood test, acute tubulointerstitial nephritis manifests itself as hypercalcemia. Impaired channel function leads to metabolic acidosis. With ultrasound, the echogenicity indicator is much higher due to the development of swelling of the organ and the process of infiltration. Ultrasound shows an increase in kidney size, an increase in the rate of radioactive gallium and leukocytes noted in the process by radionuclides. A positive scan result indicates tubulointerstitial nephritis. Diagnostics that reveal a negative result must be confirmed by other methods.
Symptoms of the disease
In the first stages of the disease, symptoms do not appear. Some patients are unaware of the developing pathology. Later periods of the course of the disease make themselves felt by expressive signs:
- rashes appear partially or on the entire surface of the body, which are itchy in nature;
- temperature rises in small limits, severe cases are noted by a febrile state;
- pain in the kidneys is felt constantly or with frequent passing attacks;
- fatigue increases, the patient feels rolling drowsiness;
- pressure surges for no apparent reason;
- polyuria occurs.
Many many-sided manifestations noted tubulointerstitial nephritis. Symptoms are observed in the form of fever and rashes, but these changes in the body alone are not enough to make a diagnosis. The rash occurs a month after the action of the toxin or for 3-6 days. It depends on the condition of the body and its reaction to the allergen. There is weight loss, pain in the abdomen and in the back over the buttocks.
A disease that has progressed to a chronic stage is distinguished at some period by mild symptoms, worsening over time. Some people develop nocturia and polyuria. An increase in blood pressure and swelling of the extremities are not observed until renal failure occurs. The symptoms described in the list are characteristic of the acute stage of the disease.
Chronic jade
The disease becomes chronic after an acute course. But such cases are rare. Most often, chronic nephritis develops after a previous infection, persistent metabolic disturbances in the body, and constant drug intoxications. Chronic tubulo-interstitial nephritis on an ultrasound scan shows the glomeruli in normal condition or destroyed. The tubules are absent altogether or deformed. Various lumens of the canals are noted - from narrowed to wide with homogeneous membranes.
Renal tissue is susceptible to fibrosis and inflammatory processes. If multiple fibrosis is absent, then the parenchyma looks almost healthy. Atrophied kidneys are small and asymmetrical. Symptoms of chronic nephritis are similar to those in the acute stage, but have a less pronounced manifestation. Leukocytosis and increased red blood cell count are rare. The chronic course of the disease is very dangerous, so you need to carefully listen to the symptoms in the early stages of the disease. Untimely treatment leads to renal failure, which is fraught with great trouble.
Acute course of the disease
Often arises due to improper self-treatment without consulting a doctor. The inability of the kidneys to perform their functions, the appearance of acute inflammatory processes appear after a long time of use in the treatment of beta-lactamide antibiotics.
Acute nephropathy is characterized by the presence of peripheral edema and inflammatory infiltration. They spread to the kidney tissue. Before the onset of severe symptoms, several weeks sometimes pass. Then acute renal failure develops , which is provoked by the untimely start of treatment and the ongoing exposure to the irritating factor.
Baby Jades
The opportunity to avoid the development of the disease in childhood is the timely visit to a doctor in case of any ailments, starting with colds. It is impossible to self-medicate, only a practicing pediatrician will pick up medications that do not harm the child's immature immune system.
Tubulo-interstitial nephritis in children is treated under the supervision of a specialist. In parallel, a therapeutic diet is prescribed, without which positive results are more difficult to achieve. In the case of advanced nephritis, a diseased kidney cannot be cured, then they resort to organ transplantation. For children, a wave-like course of the disease with a long latent period is characteristic.
Disease prognosis
If kidney function is impaired due to the use of drugs, tubulointerstitial nephritis occurs. Treatment in mild cases is not required. They stop taking the medicine, and the kidneys begin normal work after 2-2.5 months. Sometimes the residual phenomenon is the presence of scars. With a disease of another etiology, the cause is eliminated, but the disease is reversible. In severe cases, renal failure and fibrosis remain.
The prognosis of a chronic form of nephritis depends on the speed of detection and reduction of pathology before an irreversible form of fibrosis appears. If it is impossible to correct genetic, toxic and metabolic changes, the ailment passes into thermal renal failure.
Disease treatment
At the first symptoms of the disease, you need to see a doctor. Only he will choose the right and competent treatment. Therapy for each patient is individual. But, for example, glucocorticoids are used to accelerate recovery in the acute stage of the disease, and sometimes chronic. Inhibits the process of taking angiotensin blockers, inhibitors.
Kidney biopsy
The procedure relates to diagnostic measures to detect kidney disease. Represents a piece of tissue for microscopic examination. A small amount of renal material is collected through a thin syringe needle. Such a study helps to effectively determine the chemical composition of the tissue and select the optimal treatment method.
Indications for biopsy procedure
A biopsy study is prescribed in the following cases:
- Until the end, it is not possible to find out the cause of a chronic or acute disease.
- There is a suspicion of jade.
- Renal failure is rapidly progressing.
- There is a complex infectious etiology.
- In laboratory tests of urine, an admixture of blood and protein was detected.
- A blood test shows a large amount of uric acid, creatinine, urea.
- Oncology is suspected.
- A transplanted kidney is functioning with problems.
- There is a need to determine the degree of damage.
- To monitor the progress of treatment.
Types of Biopsy
The procedure is done through the skin. It is carried out using an injection over the kidneys and is controlled by x-ray or ultrasound. To facilitate the finding of an organ, a contrasting color neutral substance is introduced into the veins. An open biopsy procedure is characterized by taking a small amount of tissue directly during surgery. For example, when an oncological neoplasm is removed. The procedure is shown to those who have bleeding or have only one kidney in working condition. This is done to reduce the risk of exposure to it.
A joint biopsy with urethroscopy is performed if there are stones in the ureter or renal pelvis. It is done in the operating room and represents the introduction of a flexible tube for internal examination of the ureter. A trans-jar biopsy is the insertion of a catheter into a selected renal vein. It is used in patients with obesity, chronic respiratory failure and poor blood coagulation, when none of the above methods is performed due to a threat to life and does not reveal tubulointerstitial nephritis.
In conclusion, it should be said that the disease, which at first glance proceeds without symptoms that do not disturb the patient, in fact, needs to be detected on time. Complicated and untreated nephritis weaken kidney function and lead to irreversible effects.