Interstitial nephritis is a disease characterized by inflammation of the kidney tissue and tubules. This disease can develop due to a particular infection. In addition, it may form due to the use of certain medications. The appearance of this disease is often affected by metabolic disorders, intoxication, and in addition, the formation of malignant tumors. A phenomenon such as interstitial nephritis occurs in acute or chronic form. Next, we find out what symptoms and manifestations accompany the development of this disease in humans. And also find out what treatment is carried out.
Basic disease information
So, interstitial nephritis acts as an inflammatory pathology of the kidneys, which has a non-infectious abacterial nature. In the presence of this disease, pathological processes occur in interstitial tissues and affect the tubular apparatus of the nephrons.
This disease is considered an independent nosological form. It differs from pyelonephritis, first of all, in the presence of pathology, any destructive changes in the renal tissues do not occur, that is, the process of inflammation does not extend to the region of the cups and pelvis.
Interstitial nephritis (ICD 10 N 11.0) can manifest itself at absolutely any age. It can occur even in newborns or among elderly patients. But most often this disease is recorded in the age category of twenty to fifty years. The clinic of interstitial nephritis is characterized by a decrease in the functionality and performance of the renal tubules, in this regard, the pathology presented can be called tubulointerstitial nephritis or tubulointerstitial nephropathy.
Acute and chronic form of the disease
Acute interstitial nephritis is usually expressed as inflammatory changes in interstitial tissues. In more severe cases, this process can provoke the development of kidney failure. True, this disease is distinguished mainly by a favorable prognosis.
Chronic interstitial nephritis is characterized by fibrosis of interstitial tissues, damage to the renal glomeruli, and in addition, tubular atrophy. The chronic type of the disease leads to nephrosclerosis. This form of the disease can cause chronic kidney failure.
Interstitial nephritis occurs in children.
According to the development mechanism, such forms are distinguished:
- Primary. In this case, the pathological process develops in the kidney tissue independently, and not against the background of another disease.
- Secondary. It develops against the background of an already existing kidney disease and significantly complicates its course. It can also develop due to the presence in the body of leukemia, diabetes mellitus, gout and other diseases.
The main causes of pathology
The main causes of this disease include a number of different factors, for example:
- Use for the treatment of various medicines. We are talking about antibiotics, fluoroquinolones, non-steroidal drugs, sulfonamides, diuretics, for example, the use of Penicillin, Ampicillin, Cephalotin, Gentamicin, Ibuprofen, Captopril, Naproxen and so on.
- Past infectious pathologies that are caused by various bacteria, for example, streptococcus or diphtheria.
- Past diseases caused by viruses, for example, cytomegalovirus or hemorrhagic fever.
- The presence of diseases of the immune system, for example, the development of systemic lupus erythematosus.
- The development of myeloma.
- Heavy metal poisoning, for example, lead, mercury, cadmium and the like.
- A metabolic disorder in humans.
In the event that the main cause of interstitial nephritis remains unclear, then it is called idiopathic. Now find out what symptoms accompany this disease.
Symptoms of the disease
The clinical symptoms of interstitial nephritis directly depends on the degree of intoxication, and in addition, on the level of intensity of the development of the disease. Symptoms of the acute form of this pathology usually appear three days after the appearance of infectious diseases, such as, for example, tonsillitis, tonsillitis, flu, sinusitis and so on. Symptoms may also appear after using antibiotics, medicinal serums, and diuretics.
Most often, against the background of chronic interstitial nephritis, patients experience weakness along with lethargy, loss of appetite, nausea or vomiting. Often, all these symptoms can be accompanied by fever. Muscle pain, an allergic rash on the skin, and in addition, a slight increase in pressure are also possible.
For an acute form of interstitial nephritis, urination is not characteristic and edema does not occur. Exceptionally in extremely severe cases of this disease in patients, the amount of urine may decrease. This can occur until the complete cessation of urinary flow, thus developing anuria.
Symptoms of interstitial nephritis are very unpleasant.
From the first days, patients can also develop renal failure of varying severity, however, with adequate treatment, these manifestations are completely reversible. They usually go away after a couple of weeks. Concentration functions of the kidneys most often normalize after three months.
Symptoms of interstitial nephritis also depend on the form of the disease.
Forms of the disease
In addition to the main forms of the disease (acute and chronic), this pathology is further divided into four of the following types:
- The development of a developed form of interstitial nephritis. In this case, the patient has all the clinical symptoms of the disease.
- Against the background of a severe form, manifestations of acute kidney failure along with prolonged anuria can be expressed.
- With the development of an abortive form in patients, anuria is absent, and, in addition, a favorable course of the disease is observed along with a rapid restoration of kidney function.
- With the development of the focal form, a weak severity of the clinical symptoms of interstitial nephritis is observed. Polyuria may occur, which will result in excessive urine formation. This type of disease is characterized by a favorable course, with it, patients quickly recover.
It should be noted that chronic nephritis differs from the acute form in a more unfavorable course. In the later stages of the disease, changes in the functioning of the kidneys are noted, glomerulosclerosis develops. At the same time, the development of chronic kidney failure is not excluded.
Among the symptoms of interstitial nephritis in adults, wave fever is often observed along with an allergic itchy rash, lumbar pain, anuria or polyuria, dry mouth and thirst, increased pressure and anemia. The development of glomerulosclerosis can lead to swelling and proteinuria. The prognosis of therapy for the chronic form of interstitial nephritis directly depends on the rate of development of renal failure. In addition, the prognosis depends on the degree of damage to the renal tangles.
Acute nephrotoxicity mechanisms
Specialists distinguish five mechanisms of nephrotoxicity in the development of acute interstitial nephritis:
- The process of redistribution of renal blood flow along with its decrease.
- The development of ischemic lesions of the glomerular and tubular basement membranes.
- The occurrence of a delayed hypersensitivity reaction.
- The process of direct damage to tubule cells through enzymes in the presence of anoxia.
- The development of selective cumulation in the kidneys.
The nature of the dysfunction of the tubules can vary greatly depending on the location of the lesion.
Recommendations for interstitial nephritis will be given below.
Diagnosis of this pathology
As part of the diagnosis of this disease, the following methods of examining a patient are undertaken:
- An analysis of the patient's complaints along with a history of the disease.
- The study of a general blood test.
- Biochemical analysis of urine.
- Sampling of Zimnitsky and Robert.
- Conducting a serological study.
- A study to determine the specific microglobulins present in urine.
- Urine culture to identify and identify bacteria.
- Performing an ultrasound examination of the kidneys.
- Taking a kidney biopsy.
In addition to the above research methods, other diagnostic methods can be carried out at the discretion of the attending physician.
Therapy
It is extremely important for the treatment of interstitial nephritis early diagnosis along with the abolition of medications that provoke the development of this disease. If possible, the number of drugs used should be reduced by replacing them with nephrotoxic agents and non-toxic drugs. Against the background of polyuria, the volume of fluid used should be increased, but with oliguria, on the contrary, it should be reduced. Patients with oligoanuria are prescribed hemodialysis, which helps to restore kidney function. If necessary, a short course of glucocorticoid treatment is carried out, and in addition, cytostatics are used.
The prognosis of therapy for acute form of interstitial nephritis, as a rule, is favorable. The patients recover immediately after a few weeks, in extreme cases, it takes a couple of months. Against the background of a slow recovery of renal function and with prolonged anuria, acute interstitial nephritis can go into a chronic form.
The development of the chronic form of the disease without fail requires the restoration of the patient's water and electrolyte metabolism. Among other things, measures are being taken to eliminate the causes of damage to interstitium. Also, therapy is aimed at normalizing the functions of the urinary tract. On top of that, there is a therapy aimed at treating chronic kidney failure.
Clinical recommendations for interstitial nephritis should be strictly followed.
Disease treatment program
Treatment of such a problem should be aimed at eliminating provoking factors and at restoring renal function. Thus, therapy is carried out according to the following scheme:
- The exclusion of causal factors causing the development of the chronic nature of the disease. To do this, completely cancel the drugs that caused the pathological processes.
- In the event that there are no symptoms of chronic pyelonephritis, then a physiologically complete diet is prescribed for patients, which is able to provide a sick person with the necessary amount of carbohydrates, proteins, fats and, of course, vitamins. It is equally important to limit the patient in the use of table salt. This is especially advisable in the presence of high pressure.
- The symptomatic treatment of interstitial nephritis. Such therapy should include the use of drugs called Enalapril. This drug is able to favorably affect renal hemodynamics, due to which the level of proteinuria is reduced.
- It is also necessary to prescribe steroid hormones. This is especially true if the jade has begun to progress rapidly or is characterized by an extremely severe course.
- Carrying out an adjustment in the body of a low content of sodium and potassium as a result of too frequent urination.
- The use of medicines that improve the state of microcirculation. For example, in this case, patients should be prescribed drugs in the form of Curantil and Troxevasin.
Possible complications in the development of pathology
Against the background of the development of a disease such as interstitial nephritis (ICD N 11.0), the following complications are likely to appear in patients:
- Acute or chronic form of kidney failure.
- The occurrence of arterial hypertension.
- The development of a chronic form of jade.
Prevention of this pathology
As part of the prevention of this disease, it is advisable to follow the following recommendations:
- The use of heavy drinking.
- A complete rejection of the prolonged use of drugs that are potentially dangerous to the kidneys.
- Conducting a regular urinalysis.
- Remediation of any chronic foci of infection.
- It is very important to try to avoid hypothermia. Thus, compliance with thermal conditions is necessary.
- It is very important to conduct a study of urine in the background of each disease. Among other things, this should be done before and after various preventive vaccinations.
- A person should monitor the state of his body and not allow excessive fatigue and frequent fatigue. Therefore, excessive physical exertion should be avoided.
In the event of any symptoms that may indicate the appearance of interstitial nephritis, it is urgent to consult a therapist, and in addition to specialists such as a nephrologist or urologist. Untimely started treatment may turn out to be ineffective, as a result of which all vital kidney functions will be disrupted, while the development of insufficiency of this organ is not excluded, which means that there is a direct threat to the patient's life.