[nephro- + -pathy]
Disease of the kidney. It includes inflammatory (nephritis), degenerative (nephrosis), and sclerotic lesions of the kidney.
Damage to the tubules and interstitium of the kidneys due to overuse of pain relievers such as acetaminophen, aspirin, ibuprofen, or phenacetin.
aristolochic acid nephropathy
Balkan endemic nephropathy
A rare form of glomerular dysfunction and nephrotic syndrome, characterized by mesangial deposition of immunoglobulins and complement fragments. Most patients with C1q nephropathy are thought to have minimal change disease or focal segmental glomerulosclerosis.
SEE: focal segmental glomerulosclerosis; SEE: minimal change disease
Deterioration in kidney function resulting from the deposition of immunoglobulin light chains (and other proteins) in the distal kidney tubules.
SYN: SEE: myeloma kidney.
Chinese herb nephropathy
ABBR: CHN Progressive scarring of the kidneys caused by ingestion of guanmutong (kan-mokutsu) (Aristolochia manshuriensis ), a traditional Chinese herbal medicine. The disease most often occurs when kanmokutsu is taken with other weight loss drugs (such as fenfluramine).
Proteinuria (or microalbuminuria) in a patient with long-standing diabetes mellitus. The disease is often accompanied by high blood pressure and, eventually, by chronic kidney disease. In the U.S., it is the most common cause of end-stage kidney disease.
It may be delayed or prevented with scrupulous control of blood glucose and hemoglobin A1c levels, and by controlling blood pressure with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers.
Focal segmental glomerulosclerosis of the kidneys, occurring as a result of the injection of heroin.
ABBR: HIVAN Renal failure with nephrotic-range (massive) protein loss in the urine caused by infection of the kidneys with HIV. Biopsy of kidneys of affected patients reveals focal segmental glomerulosclerosis.
Renal damage due to hypercalcemia. It is usually caused by hyperparathyroidism, sarcoidosis, excess intake of vitamin D, excess use of calcium-containing antacids, multiple myeloma, malignant disease, and, occasionally, by immobilization or Paget disease.
Renal damage due to abnormal depletion of potassium, regardless of the basic cause of the electrolyte abnormality. Characteristically, there are multiple vacuoles in microscopic sections of the renal tubular epithelium. Clinically, the patient is unable to concentrate urine. Therapy for the primary cause of the hypokalemia may allow the kidney lesions to become completely reversed.
immunoglobulin A nephropathy
ABBR: IgAN The most common cause of glomerular disease worldwide, in which immunoglobulin A molecules deficient in galactose are deposited in the glomeruli and in other locations throughout the body. The disease, more common in males than in females, may eventually cause renal failure in as many as 40% of patients. In children, in whom the disease is most common, it typically presents with gross hematuria (blood in the urine that is visible to the naked eye). The incidence of the diagnosis is about 1 per 100,000 people annually. The disease often begins after an upper respiratory or gastrointestinal illness. It is treated with angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, scrupulous control of blood pressure, and, sometimes, glucocorticoids or fish oil.
SYN: SEE: Berger disease
A common cause of nephrotic syndrome in adults. It is typically caused by autoantibody damage (immune deposition) in structures of the basement membrane of the kidney glomerulus.
SEE: glomerular disease; SEE: nephrotic syndrome
Treatment consists of corticosteroids with or without other immunosuppressive drugs.
PATIENT CARE IMPLICATIONS
Conservative care for affected people includes excellent blood pressure control and a diet that is protein- and sodium-restricted.
Kidney damage resulting from the blockage of urinary blood flow out of the kidneys, ureters, or bladder, e.g., as a result of prostatic hyperplasia, or a tumor compressing urinary outflow. It can be identified by bladder scanning, which will reveal a large amount of retained urine or by ultrasonography of the kidneys, which will show hydronephrosis.
Acute renal failure caused by the crystallization of calcium oxalates in the renal tubules.
Precipitation of phosphate crystals in the renal tubules, e.g., after phosphate-containing laxatives are administered.
Injury to the kidney that results from the deposition of myoglobin and other myocyte debris in rhabdomyolysis. It is suggested by the identification of blood on urine dipstick testing in the absence of red blood cells on urine microscopy.
Nephropathy caused by the use of radiological contrast media, e.g., the dye used during angiography. It is usually defined as one of the following: an increase in the serum creatinine of 0.5 mg/dL within 48 hr of exposure to contrast agents when no other cause is apparent; a decrease in renal function of 25%; or any deterioration in renal function that results in clinically significant adverse effects on a patient’s health.
Kidney damage due to injected contrast occurs most often in people who are dehydrated or have diabetes mellitus, heart failure, impaired renal blood flow or kidney disease, liver failure, or multiple myeloma. It sometimes results in serious illness and death, increased hospital length of stay, and end-stage renal disease. Health care professionals should acquire complete medical histories and baseline blood tests to identify at-risk patients. Aggressive preprocedure hydration with sodium bicarbonate in saline decreases the incidence of radiocontrast nephropathy (RCN) in at-risk patients. Maintaining a urine volume more than 150 mL/hr before, during, and after contrast-requiring procedures reduces the rate of RCN significantly.
Chronic kidney disease due to kidney damage from vesicoureteral reflux (and repeated episodes of pyelonephritis).
Chronic kidney disease of unclear cause identified in agricultural workers in India. Similarly: Mesoamerican nephropathy (kidney disease in Central American agricultural workers); and Sri Lanka Nephropathy (in workers living on the island of Sri Lanka—formerly Ceylon).
Etymology: Uddanam, a village in Andhra Pradesh, India.
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