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NEPHRITIS

NEPHRITIS. aka Kidney Infection (pyelonephritis), glomerulonephritis, . Definition: Pyelonephritis = a specific type of urinary tract infection (UTI) that generally begins in your urethra or bladder and travels up into your kidneys.

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NEPHRITIS

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  1. NEPHRITIS aka Kidney Infection (pyelonephritis), glomerulonephritis,

  2. Definition: • Pyelonephritis = a specific type of urinary tract infection (UTI) that generally begins in your urethra or bladder and travels up into your kidneys. • Glomerulonephritis = a type of kidney disease that damages your kidney’s ability to remove waste and excess fluids

  3. Etiology and Pathophysiology • Affects the renal pelvis and parenchyma • Infection develops in scattered areas and spreads from renal pelvis to cortex • Kidney becomes edematous • Abscesses may develop • Tissue destruction primarily affects the tubules • Scar tissue replaces normal tissue and affected tubules atrophy

  4. E-coli is the most common cause • Proteus and Klebsiella bacteria are less common • Acute form: usually caused by bacterial infection • Chronic form: associated with nonbacterial infections such as metabolic, chemical, or immunologic disorders. • Vesicoureteral reflux

  5. Symptoms of Kidney Infection • Fever • Back, flank, or groin pain • Abdominal pain • Frequency in urination • Strong urge to urinate • Burning or pain on urination • Pus or blood in the urine

  6. Causes of Kidney Infection • Typically occurs when bacteria enters the urinary tract through the urethra • Bacteria from infection elsewhere in the body can spread through the bloodstream and infect the kidneys. • Rarely, after kidney surgery

  7. Risk Factors • Female anatomy • Poor hygiene • Obstruction in the urinary tract • Weakened immune system • Damage to nerves around the bladder • Prolonged use of a urinary catheter • Urine flowing the wrong way • Congenital malformations • Diabetes mellitus

  8. Complications of Kidney Infection • Permanent kidney damage • Septicemia • Pregnancy complications

  9. Tests and Treaments • Urine studies: urinalysis and urine culture; 24-hour urine collection, clean catch urine specimen or urinary catheterization (creatinine clearance, or protein) • Ultrasonography: size, shape and position • Blood studies: BUN, Serum creatinine clearance

  10. Treatment • MEDICATIONS • Antimicrobials – Sulfonamides (Bactrim; Septra) • Antispasmodics – Phenazopyridine (Pyridium) • Urine color is reddish-orange • Stains clothing • Analgesics – Acetaminophen, Ibuprofen • **lots of choices, these are examples of each

  11. Non-Pharmacologic therapies • Apply heat • If a heating pad is used, it should only be set on low and used for 30-45 minutes and then removed for 1 hour. (the rebound phenomenon kicks in if used for a longer period of time). • Hydration – helps flush bacteria from the body (no caffeine, citrus or alcohol until the infection has cleared (these products promote urgency and frequency)

  12. Prevention • Drink plenty of fluids, especially water • Urinate frequently • Empty the bladder after intercourse • Avoid feminine products in the genital area • Use proper hygiene

  13. Glomerulonephritis • A type of kidney disease that damages the kidneys’ ability to remove waste and excess fluids • Primary • Secondary

  14. Signs and Symptoms • Cola-colored or ice-tea-colored urine • Foamy urine • High blood pressure • Fluid retention (edema) • Fatigue • Less frequent urination than usual

  15. Causes • Frequently unknown • Infections: • Post-streptococcal glomerulonephritis • Bacterial endocarditis • Viral infections

  16. Immune Diseases • Lupus • Goodpasture’s syndrome • IgA nephropathy • Vasculitis • Polyarteritis • Wegener’s granulomatosis • Conditions that cause scarring of the glomeruli • HTN • Diabetic kidney disease • Focal segmental glomerulosclerosis

  17. Complications • Acute Kidney Failure • Chronic Kidney Failure • High Blood Pressure • Nephrotic Syndrome

  18. Tests and Diagnosis • Blood tests = creatinine, BUN • Urinalysis • Kidney Biopsy • Imaging tests • IVP (kidney x-ray) • CT Scan(computerized tomography scan)

  19. Treatment and Drugs • Treatment is dependent on: • Whether you have an acute or chronic form of the disease. • The underlying cause • The type and severity of your signs and symptoms

  20. To control HTN and slow the decline of kidney function: • Diuretics • Angiotensin-converting enzyme (ACE) inhibitors • Angiotensin II receptor agonists

  21. Treatment of Underlying Causes • R/T bacterial infections = appropriate antibiotic • R/T Lupus or Vasculitis = corticosteroids and immune-suppressing drugs • R/T IgA nephropathy = fish oil supplements are under study • Goodpasture’s syndrome = Plasmapheresis

  22. Patient Education • Seek prompt treatment of a strep infection causing a sore throat or impetigo • To prevent infections such as HIV and hepatitis, use safe sex practices and avoid IV drug use • Control blood sugar to help prevent diabetic nephropathy • Control your blood pressure

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