Nephritis (Bright’s Disease) (Acute And Chronic Stages)
‘Nephritis’ means inflammation of the kidney which con¬dition is actuated by many causes and is one ofthe most serious of renal disorders. Moreover, it is a non-specific term which points to variety of causes. The onset, development and termination are quite variable and differ from person to person, depending on the status of the disease.
Predisposing Causes
Age & Sex (not very common in Children & Ladies) Heredity (Not always a necessary cause) Occupation of a person Pregnancy
Infections of heart and alimentary tract. Exciting Causes Toxins
Use of Certain drugs that impair normal functioning of kidneys
Foods – either Vitiated or poisonous (containing Ptomaine -poison)
Infectious disorders, especially the eruptive ones.
Traumatism
Degenerative changes
Use of Potassium salts, Cantharis, Mercury, Salicylates, Jurniper and irritating drugs.
Bad effects of fevers, Kalazar, Malaria, Typhoid etc.
Impaired functioning of excretory organs. Exposure to damp or cold conditions.
Symptoms
– Fever in majority of cases
– Pain and burning at the time of micturition. Pain could be felt before, during or after making water, or it could be at one, two or all the three stages.
– Nausea and Vomiting.
– Urine passed is scanty, purulent (having pus), bloody, tainted or smoke-coloured..
– Pain and tenderness in the loins may radiate to groins/testicles/ thighs.
– Pain in spinal region.
– Occasional suppression of urine.
– Delirium and/or Coma, and finally.
– Even death may occur.
– Increase in blood pressure.
– Gradual progression of toxaemic state(s)
– Convulsions Treatment
Amount of recovery is not very favourable and en¬couraging. If one kidney is affected, there is every hope that the unaffected and healthy kidney will do the job for the other (dis¬eased) kidney also. But, when both the kidneys are involved, there is hardly any chance of survival. All said and done, effort should always be made to save the kidney from total damage and also that the infection doesn’t percolate to the healthy kidney which will do the job for the other (diseased) kidney also. But, when both the kidneys are involved, there is hardly any chance of survival. All said and done, effort should always be made to save the kidney from total damage and also that the infection does not percolate to the healthy kidney.
It is necessary to ascertain the type and depth of infection and also whether it could be controlled by treatment and its nor¬mal (or at least near-normal) function could be restored. Further concomitant complications should also be simultaneously treated.
Auxiliary measures : Following supportive steps may be taken to begin with.
1. Paroxysmal pains should be controlled by giving analgesics and antispasmodic drugs like SpasmoProyvon (one cap. 3-4 times daily) or, Neo-octinum (1-2 dragees 3-4 times daily). In severe pain tablet of Trigan (1-2 tablet 2-3 times daily) or an injection of the same in emergent and acute cases of pain.
2. Restore free flow of urine by giving one tablet of Lasix which may be repeated, if necessary.
3. If oedema is present a single dose of Lasix (20-80 mg) should be given daily or on alternate days. If hypertension persists -one tablet once or twice daily may be given or till B.P. returns to normal limits but do not continue beyond that.
4. Alkasol or Alkacitron – 1 -2 TSP 3-4 times daily.
Antibiotic Treatment
It is wiser to get urine tested for culture and sensitivity test so as to know which of the antibiotics will suit best. Generally following list of medicines will suffice to cure the infection, un¬less there is a specific reason to use only one drug.
– Norfloxacin 400 mg cap/tab twice daily for 7 days at least but in chronic cases for 3-4 weeks (if infection still persists, as revealed by requisite urinary tests) or even for 12 weeks. or – Nalidixic acid-500 mg tablets twice daily or as directed above.
Ordinary and uncomplicated Nephritis may be easily controlled by a tablet of Septran-D.S (for 7 days) twice daily for 5-7 days, and repeated immediately after 5-7 days or by giving a gap or 5-7 days or as the situation demands.
Note : The above-mentioned dosage pertains to in case of adults but for children and pregnant ladies or even for debilitated aged persons, consult some doctor and also read carefully relevant literature provided by the companies.
Case of acute Nephritis should be handled by a doctor only as even slight delay might prove fatal for the patient. Kidney func¬tion test (K.F.T), urine test (Routine, microscopic, culture and sen¬sitivity) will determine the state at which the malady has reached. Coconut water, aerated soda water, plenty of plain water, non-irritating fruit juices, whey can facilitate free flow of urine but for rest ofthe complications, medicines are needed.