Kidney disease

Nephropathy (from ancient Greek ὁ νεφρός o nephros = the kidney; τὸ πάθος to pathos = the ailment, chronic disease) or kidney disease or renal disease are terms for diseases of the kidney.

The term is mostly used for kidney diseases of a degenerative nature. It was introduced in 1905/1917 by Friedrich von Müller as a label for a separate group of kidney diseases (which, according to Hugo Ribbert, are also referred to by the word nephroses). It refers to non-inflammatory, for example also toxic or hereditary, kidney damage such as:

• Analgesic anephropathy: due to long-term abuse of certain analgesics (formerly "phenacetin kidney", today, for example, diclofenac).
• Lithium nephropathy: a kidney disease that can occur with lithium therapy for bipolar disorder.
• Cast nephropathy: classic form of kidney damage in multiple myeloma.
• Chronic graft nephropathy: a loss of function of a donor kidney after a kidney transplant, often caused by certain immunosuppressants.
• Diabetic nephropathy: late complication after years of diabetes mellitus. Diabetic nephropathy is not a clearly defined clinical picture, but rather the sum of a wide variety of changes that can occur in the kidneys as a result of the diabetic metabolic state: Papillary necrosis, inflammation, vascular changes, diseases of the filtering apparatus of the kidney. - Often the diagnosis of diabetic nephropathy is not confirmed histologically. Diabetics often have numerous organ damage resulting in reduced cardiac output. This reduces the renal blood flow and, in parallel, the glomerular filtration.
• Hypertensive nephropathy: it is not uncommon for kidney disease to cause elevations in blood pressure, which in turn can lead to further kidney damage.
• Balkan nephropathy: a chronic toxic kidney disease endemic to some regions of the Balkans, caused mainly by aristolochic acids.
• HIV-associated nephropathy: a kidney disease synergistically promoted by the HI virus
• Contrast nephropathy (also contrast-induced or contrast-associated nephropathy): deterioration of renal function after intravascular application of iodine-containing contrast media.

Inflammatory (immunological or autoimmunological) kidney diseases are also often referred to as nephropathy, for example IgA nephropathy, which belongs to the idiopathic glomerulonephritis, or IgG4-associated nephropathy, an autoimmune disease.

In general, nephrosis is understood to be any histologically detectable renal disease (renal parenchymal disease with alteration of the parenchyma, with degeneration of the epithelia). Clinically, on the other hand, nephrotic (adjective of nephrosis) is distinguished from nephritic (adjective of nephritis) renal disease; distinguishing features are the signs of inflammation. Analogously, a distinction is made between a nephritic syndrome and a nephrotic syndrome.

A classic description of bilateral kidney diseases with the symptoms of edema, cardiac hypertrophy, and ocular fundus changes was made in 1827 by Richard Bright. Other pioneers in the study of kidney diseases were Franz Volhard and Theodor Fahr, Thomas Addis as well as Donald D. Van Slyke and Homer Smith.

A. Ellis divided the kidney diseases into a type I (nephritides) and a type II (nephroses). Nephroses include minimal change glomerulonephritis (lipoid nephrosis), amyloid nephrosis, plasmacytoma kidney (cast nephropathy), glomerulosclerosis and other kidney diseases with tubular deposits.

According to Wilhelm Nonnenbruch (1887-1955), the (rare) renal syndromes are distinguished from the (frequent) extrarenal renal syndromes. The distinguishing criterion here is the detectability or the absence of histological, parenchymatous or epithelial changes in the renal tissue as a sufficient causal cause of renal insufficiency. Thus, one must think of renal insufficiency without renal disease. In this regard, Carl-Erich Alken speaks of renal involvement in non-renal renal disease. 70 to 80 percent of cases of acute renal failure are due to such extrarenal syndromes ("circulatory ischemic renal failure").

See also

• Reflux Nephropathy
• chronic renal failure