Transcript 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.
 Glomerulonephritis = a type of kidney disease that
damages your kidney’s ability to remove waste and
excess fluids
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
 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
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
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
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
Complications of Kidney Infection
 Permanent kidney damage
 Septicemia
 Pregnancy complications
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
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
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)
Prevention
 Drink plenty of fluids, especially water
 Urinate frequently
 Empty the bladder after intercourse
 Avoid feminine products in the genital area
 Use proper hygiene
Glomerulonephritis
 A type of kidney disease that damages the kidneys’
ability to remove waste and excess fluids
 Primary
 Secondary
Signs and Symptoms
 Cola-colored or ice-tea-colored urine
 Foamy urine
 High blood pressure
 Fluid retention (edema)
 Fatigue
 Less frequent urination than usual
Causes
 Frequently unknown
 Infections:
 Post-streptococcal glomerulonephritis
 Bacterial endocarditis
 Viral infections
 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
Complications
 Acute Kidney Failure
 Chronic Kidney Failure
 High Blood Pressure
 Nephrotic Syndrome
Tests and Diagnosis
 Blood tests = creatinine, BUN
 Urinalysis
 Kidney Biopsy
 Imaging tests
 IVP (kidney x-ray)
 CT Scan(computerized tomography scan)
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
 To control HTN and slow the decline of kidney
function:
 Diuretics
 Angiotensin-converting enzyme (ACE) inhibitors
 Angiotensin II receptor agonists
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
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