Thursday, March 28, 2024

Pediatric Nephritis

Practice Essentials

Nephritis is an older term used to clinically denote a child with hypertension, decreased renal function, hematuria, and edema. Technically, nephritis suggests a noninfectious inflammatory process that involves the nephron; glomerulonephritis (GN) generally is a more precise term. (See Etiology.)

Diseases that produce GN are usually classified as primary (ie, diseases in which the kidney is the primarily affected organ) or secondary (ie, systemic disorders that involve the kidneys in addition to other organs, such as systemic lupus erythematosus [SLE]). (See Differentials, Workup.)

Currently, most children with hematuria and decreased renal function who do not have a presentation consistent with postinfectious GN receive a renal biopsy, leading to a specific pathologic diagnosis. In these cases, the general terms GN and nephritis are not specific enough to be very useful for treatment or prognosis. (See Etiology, Workup.)

The term nephritis is also applied to a group of unrelated inflammatory disorders known collectively as tubulointerstitial nephritis (TIN). TIN initially affects mainly the interstitium and renal tubules.

Patient education

Education about the specific nephritis is helpful. Encourage medication compliance and a healthy lifestyle (eg, maintenance of ideal body weight, abstention from smoking, exercise, avoidance of risk behaviors).

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