DISEASES OF THE KIDNEYS
Bright’s disease and nephritis are different names for a group of kidney ailments comprising the three major types of kidney disease. One of these, glomerulonephritis, is commonly called Bright’s disease or nephritis. However, two other types also belong to the same family.
These diseases are serious because both kidneys are involved. It is the kidneys’ function to remove the waste products of the body. If they cannot function properly because of disease, the waste products accumulate. If they fail completely, death results.
One of these three types of serious kidney disease is the result of vascular diseases such as hypertension (high blood pressure).
Another type, pyelitis, is an infection of the kidneys, usually in the larger portions of the urine-collecting tubes. There may be pain in one or both sides of the lower back, accompanied by fever and a burning sensation on urination. When pyelitis infects the deeper portion of the kidney, it is called pyelonephritis.
Glomerulonephritis, which I shall refer to as nephritis or Bright’s disease, is a widespread inflammation of both kidneys. The delicate membranes of the filtering units of the kidneys are affected, and proteins and blood cells pass out into the urine. The presence of the blood proteins, especially albumin, and of red blood corpuscles in the urine suggests nephritis, especially if the physician finds certain other microscopic structures called casts in the urine.
An acute attack of Bright’s disease does more than damage the kidney. It affects the blood capillaries of the entire body so that water leaks out into the tissues. In a typical attack, the eyes look swollen and puffy, and the ankles as well as other parts of the body may be distended with painless accumulations of oedema fluid.
There is a special form of nephritis that deserves mention: this is nephrosis. In children, it may last for years and eventually clear up completely, provided infections and complications can be avoided during this long period of time. In adults, nephrosis is a stage of the Bright’s disease just described. It tends to become irreversibly chronic more frequently than in children.
‘Uraemia’ means, literally, ‘urine in the blood.’ It results when the kidneys are so badly damaged that they can no longer purify the blood of urea and the other waste products of the body’s metabolic activities.
When the kidneys are completely destroyed, the human being cannot live longer than a few weeks. However, by the use of an artificial kidney machine through which the blood is circulated and purified of waste products, life can be prolonged.
When the kidneys are irreversibly damaged by advanced disease, such as Bright’s disease or pyelonephritis, the person may go to a large hospital once or twice a week for purification of the blood by the artificial-kidney machine through a process known as dialysis. Use of some form of artificial kidney in the home appears to be a possibility in the foreseeable future.
Diabetes
Despite modern treatment, diabetes may affect the blood vessels in much the same way as high blood pressure. It may damage the coronary arteries of the heart or the blood vessels in the retina of the eye, and it may affect the circulation in the kidneys and the brain. Thus, a diabetic person may suffer from heart trouble because the coronary arteries are not working properly.
If the kidneys are badly affected, the person may seem to be suffering from advanced Bright’s disease. This combination of diabetes and nephritis may end in uraemia.
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