Types of kidney inflammation (nephritis), are the number 5 cause of kidney failure in the US. These problems are rare: all told, each year they cause less than 5% of kidney failure. Here are some of the problems that can cause the kidneys to become inflamed:
- Interstitial nephritis – this is swelling of the spaces between the renal tubules that form urine. It is most often a short term problem caused by a drug allergy or side effect.1 Sometimes it can cause chronic kidney failure. Symptoms may include fever, confusion or sleepiness, rash, swelling, more or less urine than normal, and blood in the urine.
- Pyelonephritis is a kidney infection. It can occur if a bladder infection moves up into the kidneys. This is more likely if you have a kink or blockage in a blood vessel or ureter (tube that brings urine from a kidney to the bladder) that causes reflux — urine that backs up into your kidney. Pyelonephritis can cause a high fever, sweating, and chills; flank or back pain; changes in urine color or odor; pain when urinating; and confusion.2
- Kidney stones are sharp, pointy crystals made of substances found in the urine. If you have had one, you know that they are quite painful to pass — and you are more likely to have another.3 Kidney stones are a very rare cause of kidney failure, but it can happen.
- Gout is a common, painful form of arthritis caused by high levels of uric acid in the blood. Early on, most people have a year or more between attacks, so gout is only treated when it is active. In time, attacks can become more frequent, so drug treatment may help. Gout is a rare cause of kidney failure, but uric acid in the blood can form crystals that deposit in the kidneys, or can cause kidney stones.4
What You Can Do
Most forms of kidney infection or inflammation can be prevented or treated. You can:
- Check out new drugs. Before you take a drug for the first time, do a little homework. Look them up at http://www.rxlist.com, or ask the pharmacist if there are side effects or warnings you should know about.
- Watch for allergies. When you take a new drug, note any changes in your body. Report new symptoms to your doctor and ask if they might be due to a drug.
- Limit use of NSAIDs. These pain pills with ibuprofen, naproxen, or aspirin or COX-2 inhibitors can harm the kidneys in high doses or at low doses for long time spans.
- If you must take NSAIDs for a long time, ask for a urine protein test. Protein in the urine can be a sign that NSAIDs are causing kidney damage. This can often go away if it is caught early.
- Prevent bladder infections. Most kidney infections start in the bladder. You can help stop bladder infections by drinking plenty of fluids, wiping from front to back after using the bathroom, and urinating after sex.
- Have your urine checked after bladder infections. If you have infections that keep coming back, be sure that they are gone after treatment by asking for a urine culture. If they keep happening, ask your doctor to test you for reflux.
- Drink plenty of fluids to prevent kidney stones. Prone to stones? Keeping your urine dilute by drinking lots of fluids can help prevent them, keep them smaller, or make them pass more easily.
- Learn what your kidney stones are made of. Keep any stones you pass, and ask for a 24 hour urine test afterward so your doctor can prescribe a treatment that will work for you.
- A healthy lifestyle reduces gout. If you keep your weight and blood pressure normal, have no more than 1-2 alcoholic drinks per day, and keep your cholesterol down, you’ll make gout less likely.5
Questions to Ask Your Doctor if You Have Kidney Inflammation
- How many NSAID pills can I take before I should worry about my kidneys?
- Should I take any special precautions when I take NSAIDs? Will drinking a full glass of water after each pill help?
- What side effects should I be aware of with this drug?
- I have had ___ bladder (or kidney) infections in ___ (time). What tests do you suggest to rule out reflux from a kink or blockage?
- What should I eat or drink (or avoid) to prevent future kidney stones?
- What should I eat or drink (or avoid) to prevent future gout attacks?
Links to Learn More
- National Library of Medicine – read about interstitial nephritis at: http://www.nlm.nih.gov/medlineplus/ency/article/000464.htm
- National Library of Medicine – read about pyelonephritis at: http://www.nlm.nih.gov/medlineplus/ency/article/000522.htm
- What I Need to Know About Kidney Stones – read all about it from the National Institutes of Health: http://kidney.niddk.nih.gov/kudiseases/pubs/stones_ez/
- Download a free booklet on gout – the National Institute of Arthritis and Musculoskeletal and Skin Diseases offers this information: http://www.niams.nih.gov/hi/topics/gout/gout.htm
- Learn about gout from the Mayo Clinic, at: http://www.mayoclinic.com/health/gout/DS00090