How Does Brights Disease Develop?
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About Bright's Disease
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Bright's disease is a term that refers to a group of symptoms documented by English physician Richard Bright. Though Bright himself believed that the symptoms were caused by one specific disease of the kidneys, it is now known that there are several different kidney conditions that may produce the symptoms he described: back pain, fever, vomiting, edema and dark urine. Bright was the first to connect these symptoms with kidney disease, and he is still considered a pioneer in the field of nephrology. The name Bright's disease is now used primarily in a historical context as advances in medicine have led to the usage of more specific nomenclature.
Nephritis
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Nephritis is the inflammation of the kidneys, producing the symptoms described by Bright. However, nephritis affects specific parts of the kidneys, leading to the following, more accurate terms:
Interstitial nephritis is the inflammation of the tissue between the renal tubules. This is most often caused by an allergic reaction to medication such as antibiotics or non-steroidal anti-inflammatory drugs, but may also be caused by infection. If diagnosed early the offending drug can be removed or the infection treated, and normal kidney function will usually return. Chronic interstitial nephritis can lead to damage of the tubules themselves, which cannot be reversed. Renal failure is possible.
Pylenonephritis is the inflammation of the pyelum of the kidney, located in the center of the kidney next to the ureter. It is also called the renal pelvis. Pylenonephritis is nearly always caused by bacteria, generally from an ascending urinary tract infection. As the infection progresses, the tubules can become damaged, followed by the glomeruli and other blood vessels. Fibrosis and scarring are possible. Pylenonephritis is treated with antibiotics, either orally or intravenously, and early diagnosis along with patient follow-ups to treat possible relapse can ensure that there is no permanent damage.
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Glomerulonephritis
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Glomerulonephritis is the Inflammation of the glomeruli, the capillaries within the kidneys. There are a number of different causes for this condition.
Non-proliferative types are caused by low numbers of cells in the glomeruli. This may be caused by kidney scarring due to disease or drug use, or can be idiopathic in nature. Treatment is usually with steroids, though the disease may continue to progress.
By contrast, proliferative types are caused by too many cells in the glomeruli. This may be due to infections of the gastrointestinal and respiratory tracts, the skin or the pharynx. If lab tests indicate the presence of immunoglobulin A, ACE inhibitors are used for treatment; otherwise, the condition will likely resolve on its own.
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Resources
- Photo Credit English physician Richard Bright (1789 to 1858).
