Nephropathy

Nephropathy is a broad medical term referring to disease or damage of the kidneys. It encompasses conditions that impair kidney structure or function, including dysfunction of glomeruli, tubules, interstitium, or renal vasculature. Nephropathy can be acute or chronic and may progress to kidney failure if untreated.

Common types include diabetic nephropathy, hypertensive nephropathy, glomerulonephritis (inflammation of glomeruli), tubulointerstitial nephropathy, and nephrotoxic nephropathy caused by drugs or toxins. Less common causes include polycystic kidney disease, autoimmune diseases, infections, and ischemic injury.

Symptoms may be absent early; as disease progresses, signs include swelling of ankles and legs, fatigue, decreased urine output, dark or foamy urine, and elevated blood pressure. Laboratory clues include proteinuria or albuminuria, hematuria, reduced estimated glomerular filtration rate (eGFR), elevated serum creatinine or BUN, and electrolyte disturbances.

Diagnosis combines history, physical findings, laboratory testing, urine analysis, imaging, and sometimes kidney biopsy to determine etiology and extent. Management focuses on treating the underlying cause and slowing progression: glycemic control in diabetes, blood pressure control (often with ACE inhibitors or ARBs), avoidance of nephrotoxins, dietary adjustments, and management of complications. In advanced cases, dialysis or kidney transplantation may be required.

Prognosis varies with cause and stage at diagnosis; early detection improves outcomes. Ongoing research aims to identify biomarkers and therapies to reduce kidney injury and preserve function.