Nephritis

{nef-ri’-tis) [yeopog, the kidney; trig, inflammation]. Inflammation of the kidney. The inflammation when affecting the epithelium is termed Parenchymatous N., which may be acute or chronic. It is also known as Tubular, Catarrhal, or Desquamative N., or, when affecting especially the glomerule, as glomerulonephritis. That involving the connective ti ue chiefly is called Interstitial N., and may also be acute or chronic. The acute gives rise to absce of the kidney. A nephritis in which both elements are involved is termed Diffuse N. In Acute Parenchymatous N., or acute Bright’ s disease, the kidney is enlarged, congested, its structural markings are obscured, the epithelium is in a state of cloudy swelling or fatty degeneration, and many tubules contain casts; in others the epithelium is desquamated. The symptoms are fever, lumbar pains, and often dropsy; the urine is scanty and contains albumin, blood, casts, and epithelial cells; uremia is common. In Chronic Parenchymatous N. (large white kidney) the kidney is enlarged, pale or yellow, and soft; the epithelium presents an advanced stage of fatty degeneration. Casts are often present. The symptoms are anemia, dropsy, gastrointestinal disturbances, dyspnea, and retinitis; the urine is scanty and contains a large amount of albumin, granular, fatty, and waxy casts, and compound granule-cells. Acute interstitial N. is due to septic infection either through the blood, as in pyemia, or through extension along the ureter or from neighboring structures. In chronic interstitial N. (granular or gouty kidney), the kidney is small, hard, the capsule is adherent, the surface is granular and marked by cysts. The cortex is diminished in thickne . Microscopically there is a marked increase in the connective ti ue about the tubules, the glomeruli, and the blood-ve els. The glomeruli show degenerative changes, the epithelium is atrophic and degenerated. The symptoms are anemia, lo of flesh and strength, disturbances of digestion, dyspnea, and asthmatic attacks; polyuria, the urine being of a low specific gravity, pale, and containing only a small amount of albumin and but few hyaline casts. There is also hypertrophy of the heart and sclerosis of the arteries; the pulse is of high tension, and the second aortic sound is accentuated. Uremia is common. N., Saturnine, that due to chronic lead-poisoning. N., Scarlatinal, an acute nephritis due to scarlet fever. N., Tuberculous, that due to the presence of tubercle-bacilli. It presents itself either in the form of caseating ma es or cavities in the substance of the kidney, or as miliary tuberculosis of the organ. 433