nephritis procedure preparation

Overview

Nephritis is a condition where the tiny filters in your kidneys (called glomeruli) become inflamed. This inflammation can affect how well your kidneys remove waste and extra fluid from your blood. If your doctor recommends a procedure, such as a kidney biopsy, preparation helps make it safer and more comfortable.

Nephritis is not very common, but it is a serious condition that can affect anyone. About 1 in 1,000 people may develop some form of nephritis during their lifetime.

Nephritis can affect people of all ages, but certain types are more common in children (e.g., post-streptococcal glomerulonephritis) and older adults (e.g., membranous nephropathy). People with autoimmune conditions like lupus are also at higher risk.

Symptoms

Common symptoms

• Blood in urine (pink, red, or cola-colored)
• Foamy urine (due to protein)
• Swelling in the face, hands, feet, or abdomen
• High blood pressure
• Fatigue and feeling generally unwell

Symptoms in children

• Swelling around the eyes in the morning
• Fever or recent throat or skin infection
• Dark or bloody urine
• Decreased urine output

Symptoms in older adults

• Sudden confusion or difficulty concentrating
• Swelling in the legs and ankles
• Shortness of breath
• Loss of appetite and nausea

Causes

Main causes

• Infections – such as strep throat, skin infections, or viruses like hepatitis
• Autoimmune diseases – like lupus or IgA nephropathy, where the immune system attacks the kidneys
• Certain medications – including some pain relievers and antibiotics (not recommended by name)
• Vasculitis – inflammation of blood vessels that can affect the kidneys

Risk factors

• Family history of kidney disease or autoimmune conditions
• Having diabetes or high blood pressure
• Repeated infections, especially streptococcal infections
• Using medications like non-steroidal anti-inflammatory drugs (NSAIDs) long-term

When to see a doctor

See a doctor urgently if:

• Any symptoms of acute kidney injury – sudden swelling, little or no urine, confusion
• High blood pressure that is hard to control
• Blood in urine that appears suddenly or with clots

Book a routine appointment if:

• If you notice foamy urine or mild swelling that lasts more than a few days
• If you have a family history of kidney disease and want a check-up
• For regular monitoring if you have diabetes or high blood pressure

Diagnosis

Nephritis is diagnosed through a combination of blood tests, urine tests, and imaging. Often, a kidney biopsy is needed to confirm the exact type of inflammation.

Tests that may be done

• Urine test (urinalysis) – checks for blood, protein, and signs of infection
• Blood test – measures kidney function (creatinine and eGFR) and looks for antibodies
• Ultrasound – uses sound waves to see the size and shape of your kidneys
• Kidney biopsy – a small sample of kidney tissue is taken with a thin needle to examine under a microscope

What to expect at your appointment

If you need a kidney biopsy, it is usually done as an outpatient procedure. You will lie on your stomach, and the area will be numbed with local anaesthetic. The doctor uses ultrasound to guide a thin needle to your kidney. You may feel some pressure but not sharp pain. After the biopsy, you will rest for a few hours and be monitored for bleeding. Most people go home the same day.

Treatment

Treatment for nephritis depends on the cause and how severe it is. The goal is to reduce inflammation, control blood pressure, and protect kidney function. Your doctor will create a plan tailored to your needs.

Self-care at home

• Stay well-hydrated (unless your doctor advises fluid restriction)
• Limit salt to help control blood pressure and swelling
• Avoid medications that can harm kidneys, such as ibuprofen or naproxen (check with your doctor)
• Monitor your blood pressure at home if advised
• Follow a kidney-friendly diet – low in protein, phosphorus, and potassium if kidney function is reduced

Medical treatments

Medical treatments may include medications to lower blood pressure (like ACE inhibitors or ARBs), diuretics to reduce swelling, and medicines that suppress the immune system (such as corticosteroids or other immunosuppressants) if the cause is autoimmune. For infections, antibiotics or antivirals may be used. Your doctor will discuss the best options for you without naming specific brands.

When is surgery considered?

Surgery is rarely needed for nephritis itself. However, if complications occur, such as a kidney stone blocking the urine flow or a severe bleeding complication from a biopsy, a minor procedure may be required. In advanced cases, dialysis or kidney transplant may be considered if kidney failure develops.

Living with this condition

Living with nephritis often involves regular check-ups, blood tests, and urine tests to monitor your kidney function. You may need to take medications daily and track your blood pressure. It is important to rest when you feel tired and to know the warning signs of worsening kidney function.

Lifestyle tips

• Follow a low-salt diet to help control blood pressure
• Limit protein, potassium, and phosphorus if your kidney function is reduced (ask your doctor or dietitian)
• Stay active with gentle exercise like walking, but avoid heavy lifting if you have recently had a biopsy
• Avoid smoking and limit alcohol
• Take all medications exactly as prescribed

Diet and exercise

A kidney-friendly diet is key. This often means reducing salt, eating moderate amounts of protein, and limiting foods high in potassium (like bananas and potatoes) and phosphorus (like dairy and nuts) if your kidneys are struggling. Exercise like walking or swimming can help maintain a healthy weight and lower blood pressure. Always check with your healthcare team before starting a new diet or exercise routine.

Mental health and emotional wellbeing

Having nephritis can be stressful and may cause anxiety or depression. You might worry about your kidney function, treatments, or future health. It is normal to feel this way. Talking to a counsellor or joining a support group can help. If you have thoughts of harming yourself, please contact a crisis helpline or your local emergency number immediately.

Prevention

Not all cases of nephritis can be prevented, but some steps can lower your risk. Treating infections promptly, managing blood pressure and diabetes, and avoiding unnecessary use of painkillers like NSAIDs can help reduce the chance of developing nephritis.

Vaccines

Vaccines for infections like the flu, pneumonia, and hepatitis B are recommended, especially if you have kidney disease or are on immunosuppressive therapy. Talk to your doctor about which vaccines are right for you.

Screening programmes

If you have risk factors such as diabetes, high blood pressure, or a family history of kidney disease, regular urine and blood tests can help detect early signs of kidney problems. Your doctor will recommend how often to get screened.

Complications

If left untreated

• Chronic kidney disease – gradual loss of kidney function
• Kidney failure – requiring dialysis or a kidney transplant
• High blood pressure that is hard to control
• Increased risk of infections, especially if on immunosuppressants
• Fluid overload leading to breathing difficulties

Long-term outlook

The outlook for nephritis is often good, especially when caught early and treated properly. Many people recover completely or have only mild long-term effects. Even if you develop chronic kidney disease, treatments can help you live a full life. Your healthcare team will work with you to manage the condition and maintain your quality of life.

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