Nephritides

Nephritides is a general term used for inflammatory diseases of the kidneys that predominantly involve the renal glomeruli. The condition spectrum ranges from mild, self-limited processes to severe, rapidly progressive diseases. Typical features include hematuria, sometimes with red blood cell casts, proteinuria (often modest rather than nephrotic), hypertension, and varying degrees of reduced kidney function. Distinguishing nephritic processes from nephrotic or tubulointerstitial diseases guides treatment and prognosis.

Causes and classification: Many nephritides are immune-mediated. Glomerulonephritis can be secondary to systemic diseases (such as lupus or vasculitis), post-infectious syndromes, or primary glomerular diseases (for example IgA nephropathy, membranous or membranoproliferative GN). Others are drug-induced tubulointerstitial nephritis or vasculitides with renal involvement. Some forms are rapidly progressive and require urgent treatment.

Diagnosis: Evaluation includes urinalysis showing hematuria and varying proteinuria, measurements of kidney function, and blood pressure assessment. Serologic tests (ANCA, anti-GBM antibodies, ANA, anti-dsDNA, complements) help identify systemic or specific immune etiologies. Kidney biopsy is often essential to define histology and guide therapy, especially in unclear or severe cases.

Management and prognosis: Treatment targets the underlying cause and kidney protection. Immunosuppressive therapy is used for many immune-mediated nephritides, while supportive care includes blood pressure control and renin–angiotensin system blockade, avoidance of nephrotoxins, and fluid management. Prognosis varies widely; some forms resolve, others lead to chronic kidney disease or end-stage kidney disease depending on extent of injury and response to therapy.