nephritis treatment options overview

Overview

Nephritis means inflammation of the kidneys. The kidneys are two bean-shaped organs that filter waste and extra fluid from your blood to make urine. When they are inflamed, they struggle to do their job.

Nephritis is not rare. It accounts for a small portion of kidney problems, but it can affect anyone at any age.

It can affect children, adults, and older people. Some types are more common in women, while others are more common in men. People with autoimmune diseases or certain infections are more at risk.

Symptoms

Common symptoms

• Swelling in your face, hands, belly, or feet
• Blood in your urine — it may look pink, red, or cola-colored
• Foamy or bubbly urine
• Urinating less than normal or needing to urinate more often at night
• High blood pressure (often found during a check)
• Feeling very tired or weak
• Pain in your back or side (less common)

Symptoms in children

• Swelling around the eyes, especially in the morning
• Fever
• Tummy pain
• Less appetite
• Not feeling like playing or being unusually tired
• Urine that looks dark, pink, or murky

Symptoms in older adults

• Swelling in the legs or ankles
• Feeling confused or unusually drowsy
• Not urinating for many hours
• Shortness of breath
• Loss of appetite

Causes

Main causes

• An infection, such as strep throat or a stomach bug, can sometimes trigger kidney inflammation a couple of weeks later.
• Autoimmune diseases — the body's immune system attacks and damages its own kidney tissue.
• Some medicines, toxins, or allergic reactions can inflame the kidneys.
• Sometimes, the cause stays unknown.

Risk factors

• Having a recent infection, especially strep throat or a skin infection
• Having an autoimmune condition like lupus or a form of vasculitis
• Taking certain pain relievers or other medications for a long time
• Having diabetes or high blood pressure
• Having a family member with kidney disease

When to see a doctor

See a doctor urgently if:

• If you see blood in your urine
• If you have swelling that gets worse
• If you are urinating much less than usual
• If you have a fever along with kidney symptoms

Book a routine appointment if:

• If you notice any symptoms that worry you, even if they come and go
• If you have a health condition like diabetes or high blood pressure and want your kidneys checked
• If you have had an infection and then feel unwell with puffiness or fatigue

Diagnosis

Your doctor will listen to your symptoms, check your blood pressure, and look at your body for swelling. They will then ask you to give a urine sample and have a blood test to see how well your kidneys are filtering.

Tests that may be done

• Urine test — to check for blood, protein, and signs of infection
• Blood test — to measure waste products like creatinine and urea in your blood
• Blood pressure measurement
• Kidney ultrasound — a painless scan that shows the size and shape of your kidneys
• A kidney biopsy — a small sample of kidney tissue is taken with a needle to look at under a microscope

What to expect at your appointment

Most of the tests are quick and painless. A kidney biopsy is done in hospital, with local anaesthetic to numb the area. You can usually go home the same day or after a few hours. The results help your doctor choose the right treatment.

Treatment

Treatment for nephritis depends on what is causing the inflammation, how severe it is, and how well your kidneys are still working. The main goals are to reduce inflammation, manage blood pressure, and protect you from further kidney damage. A kidney specialist called a nephrologist often leads the care team.

Self-care at home

• Drink the amount of fluid your doctor or dietitian suggests — too much can be bad if your kidneys are struggling, but too little can also harm them.
• Check your blood pressure at home if your doctor recommends it, and keep a record.
• Weigh yourself daily, especially if you are taking water tablets, to spot extra fluid early.
• Avoid alcohol and quit smoking to protect your kidneys and blood vessels.

Medical treatments

Doctors may prescribe medicines that calm the immune system and reduce inflammation. They may also prescribe medicines to lower blood pressure and water tablets (diuretics) to help your body get rid of extra fluid. Treatments are chosen specifically for the cause of your nephritis and your overall health. In serious cases, if the kidneys stop working, dialysis (a machine that filters your blood) or a kidney transplant might be needed.

When is surgery considered?

Surgery is rarely used to treat nephritis itself. A kidney transplant is the only major operation considered, and only if the kidneys have failed completely. This is discussed thoroughly with your kidney team.

Living with this condition

Living with nephritis involves watching your health closely. Follow your care plan, attend your appointments, and tell your doctor about anything that changes. Keep a list of your medicines and share it with any doctor you see.

Lifestyle tips

• Eat a balanced diet. Usually, your doctor will advise you to limit salt, and sometimes potassium and protein.
• Stay gently active. Walking, swimming, or light cycling can help, but rest when you feel tired.
• Protect yourself from infections by washing hands regularly and staying up to date with vaccines.
• Only take medicines — including over-the-counter ones — after checking with your doctor.

Diet and exercise

Your dietitian can create a meal plan that supports your kidneys. Most people with nephritis need to watch their salt and sometimes their protein and potassium. Light exercise is safe for most, but you should slow down if you feel breathless, dizzy, or in pain.

Mental health and emotional wellbeing

Being diagnosed with a kidney condition can bring worry, low mood, and stress. It is completely understandable. Talking to a counselor or joining an online community can help. Do not keep your feelings to yourself — your healthcare team can offer support.

Prevention

Not every type of nephritis can be prevented, but you can lower your risk. Treat infections early, manage diabetes and high blood pressure, avoid heavy or long-term use of pain medicines, drink enough water, and follow a heart-healthy lifestyle.

Vaccines

Keeping up to date with recommended vaccines may reduce your risk of infections that can lead to kidney inflammation. Talk to your doctor about which vaccines are right for you.

Screening programmes

If you have strong risk factors, such as an autoimmune disease or a family history of kidney failure, your doctor may recommend blood and urine tests on a regular basis to catch problems early.

Complications

If left untreated

• Chronic kidney disease, which gets worse over time
• High blood pressure that is hard to control
• Kidney failure, requiring dialysis or a transplant
• Fluid overload, which can affect your heart and lungs

Long-term outlook

With the right care, many people with nephritis recover completely or keep their kidney function stable for years. Even if the kidneys do become damaged, modern treatments help people live active and fulfilling lives. Your healthcare team will be by your side at every step.

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