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NEPHRITIDES: TYPES AND MANAGEMENT

I. B. Bosan

Professor of Medicine/Nephrology

Ahmadu Bello University, Zaria

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Definition

  • Inflammatory disorders of the kidney tissues

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  • Infections, autoimmune disorders, degeneration, genetic and vascular disorders

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  • Involve
    • Glomeruli mainly in the cortex - Glomerulonephrirtis
    • Outer and inner medullar mainly tubules and interstitium – Tubulointerstitial nephritis
    • Kidney pelvis usually with the adjoining interstitial tissues - Pyelonephritis

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Types

  • Acute or Chronic

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  • Involves inflammation and/or degeneration

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  • Glomerulonephritis, Interstitial (Tubulo-interstitial) nephritis, pyelonephritis and Pan-nephritis.

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  • May complicate multisystem disorder such as SLE, Vasculitides

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  • General use of the term - Nephropathies

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Management

  • Good history
    • What symptoms?
    • Onset and duration of symptoms
    • Family history of disease
    • Drug history
    • Past infections/infestations

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  • Physical examination
    • Signs of chronic disease/acute onset
    • Evidence of earlier infections
    • Signs of systemic diseases

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  • Bedside preliminary urine tests

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Management

  • Laboratory work up – side lab/Main lab
    • Urinalysis
    • Urine sediment microscopy
    • Urine biochemistry
    • Blood biochemistry
    • Haematologic parameters
    • Immunologic parameters

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  • Imaging - Xrays, Ultrasound scans, CT scan, Contrast imaging when indicated

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  • Biopsy/Histology

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Management

  • Lifestyle modification

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  • Appropriate drug therapy

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  • Counseling

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  • Follow up as appropriate