Interstitial nephritis: symptoms and treatment of renal inflammation

Interstitial nephritis is an inflammatory kidney disease that occurs with predominant lesions of the intermediate tissue and renal tubules.

The disease can occur during treatment with medications (mostly antibiotics, in lesser diuretics, sulfonamides), as well as exposure to bacteria, viruses, and immune disorders. The pathology is based on lymphohistiocytic infiltration, which affects the intermediate tissue of the kidneys after the injured basal membrane of the tubules. In this case, immune complexes and autoantibodies are formed to membrane proteins. As a result of edema and inflammation of the tissues of the medulla of the kidneys, mechanical compression of the vessels and tubules occurs, a decrease in renal blood flow, an increase in the intrachannel pressure, and as a result oligouria develops.

When the diagnosis of interstitial nephritis symptoms are manifested as follows. The onset of the disease - acute, with fever, polyuria or hematuria, develops kidney failure, pains in the lower back. The first signs of the drug form of acute interstitial nephritis are a re-increase in body temperature, which can be combined with eosinophilia and skin rashes. The disease is characterized by moderate proteinuria, hematuria, in rare cases, oliguria.

Acute interstitial nephritis of the viral form often passes with hemorrhagic fever and kidney syndrome.

Diagnosis of the disease is performed with a kidney stone disease, with acute glomerulonephritis. If kidney failure develops, other causes should be excluded.

It is very difficult, and sometimes impossible to establish the cause of chronic tubulointerstitial nephritis associated with drug exposure, bacterial infection, immune disorders.

Symptoms of chronic interstitial nephritis are in tubular disorders, rapidly developing water-electrolyte disorders (hyperkalemia, acidosis), violations of the concentration functions of the kidneys. In rare cases, hypertension and proteinuria are possible. In standard situations, a nephrotic syndrome is absent, but when the disease progresses, interstitial nephritis is practically indistinguishable from glomerulonephritis. The most dangerous drugs, leading to a chronic form of the disease, are analgesics phenacetin, analgin, aspirin.

Sometimes in women 35-40 years of age, suffering from migraine, depression, stomach ulcer, analgesic interstitial nephritis is observed. It is characterized by a combination of persistent leukocyturia aseptic with episodes of renal colic with macrohematuria, a decrease in the size of the kidneys, polyuria, anemia.

The disease develops in combination with other ailments that have a clear immune pathogenesis (active chronic hepatitis, red systemic lupus erythematosus).

Interstitial nephritis in children can develop with dysembryogenesis of renal tissue, urinary tract abnormalities, urate and oxalate metabolism disorders.

To combat the disease, aetiological treatment is used, with bacterial lesions begin with the elimination of the focus of infection. With the drug form - stop taking drugs, prescribe a diet enriched with vitamins, and a plentiful drink. In the absence of positive results, glucocorticoids are prescribed, in the development of acute renal failure, hemodialysis is performed, and the use of diuretics is excluded. Also it is necessary to avoid the increased use of analgesics and to drink more.