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Inflammation of the Tubules (Glomerulonephritis)

Glomerulonephritis occurs when the glomeruli become inflamed but are not directly infected by microorganisms. This condition, which takes several forms, is found more often in children and young adults, but is relatively uncommon.

In chronic nephritis (Bright's disease) the glomeruli become damaged over many years and are replaced by fibrous scars. This affects, and may eventually completely interrupt, filtration of the blood, leading to toxaemia and death. The cause is past kidney disease or arteriosclerosis, and treatment consists of taking preventive measures to stop the progression of the disease.

When a kidney abnormality is associated with raised blood pressure, the combination of the kidney damage and the hypertension is often called arteriolar nephrosclerosis. The disease is very common in the western world but modem methods of treatment can control this very slow, progressive complaint.

In the nephrotic syndrome, another form of glomerulonephritis, the glomerulus becomes leaky and protein is lost into the urine (proteinurea). The condition usually start between the ages of two and four, and affects slightly more boys than girls. The cause is unknown in many cases. About ten per cent of children with the syndrome will develop chronic nepritis as they grow up.

Symptoms

Symptoms of glomerulonephritis may include blood in the urine or excessively frothy urine, a symptom of proteinurea which can be detected by a simple urine test. Most of the protein lost is albumin, an important constituent of blood. The loss of albumin can result in the leakage of fluid from the blood vessels, and this in turn can cause accumulation of fluid in the tissues which results in puffiness of the face and swelling in the lower parts of the body. These symptoms may appear over a few days, sometimes after a sore throat caused by streptococci, or over a longer period. Glomerulonephritis may be discovered during a routine medical check, and in such cases the final diagnosis may require renal biopsy. A wide range of conditions can cause the syndrome.

Treatment

Many forms of glomerulonephritis are mild and require no specific treatment; other forms may be treated with corticosteroid or immunosuppressive drugs. Acute glomerulonephritis usually clears up completely. The chronic form, which may develop over months or years can, if it does not respond to any sort of treatment, lead to kidney failure.

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