nephropathies

Nephropathy is a general term for diseases of the kidney that affect its structure or function. The term encompasses disorders that damage the nephrons, including the glomeruli, tubules, interstitium, and renal vasculature. Nephropathies can be acute or chronic and may arise as primary kidney diseases or as manifestations of systemic illness. They are commonly classified by the anatomic site of injury (glomerular, tubular-interstitial, vascular) or by whether a process is intrinsic to the kidney or secondary to another condition.

Common categories include primary nephropathies such as glomerulonephritis, tubulointerstitial nephritis, and polycystic kidney disease, and secondary nephropathies from systemic diseases like diabetes mellitus, hypertension, autoimmune diseases (eg, lupus), or infectious diseases. Within these, etiologies may be genetic, metabolic, infectious, toxic, or immune-mediated. Acute kidney injury and chronic kidney disease describe the functional outcomes rather than distinct diseases.

Clinical features vary but often include proteinuria, hematuria, edema, hypertension, and reduced kidney function indicated by a rising creatinine or decreased estimated glomerular filtration rate. Evaluation relies on history, physical examination, urinalysis, measurement of proteinuria, serum creatinine/eGFR, and blood pressure. Imaging with ultrasound can assess kidney size and structure. Kidney biopsy is used when diagnosis remains uncertain or to guide therapy.

Management focuses on treating the underlying cause, protecting kidney function, and controlling complications. This includes blood pressure control with renin-angiotensin system blockers, glycemic control in diabetes, avoidance of nephrotoxins, and immunosuppressive therapy when indicated. Advanced nephropathies may require renal replacement therapy (dialysis or transplant). Prognosis depends on the cause, severity, and response to treatment.