The nature of the symptoms in conjunction with abnormalities in the blood and urine tests helps to determine the level of diagnosis and treatment. For example, if a person has normal kidney function and the protein levels in the urine are mildly above normal, your doctor will discuss closely monitoring your kidney function, as well as recommending lifestyle and dietary changes. If the condition should change, as in worsening kidney function or higher levels of proteinuria, your doctor will often recommend a kidney biopsy to help determine the type of process occurring.
The kidney biopsy procedure is usually performed by a nephrologist or interventional radiologistma type of doctor who does this type of procedure quite frequently. The kidney biopsy is not surgery and is commonly done in the radiology department. The sample that is required is roughly the same size as the white part of your finger.
nail. The whole procedure takes roughly twenty minutes and will be fully explained to you. After the sample is obtained, it will be sent to a pathologist who specializes in kidney disease, who will then examine the biopsy specimen under a microscope to determine the process of inflammation. This procedure's risks include bleeding, so you will be asked to stay in the hospital overnight for observation.
Causes of the Inflammation
What causes the inflammation in these disorders? What is the trigger that predisposes the kidney to be the recipient of these high-level inflammatory syndromes? Why are some people more inclined than others to get this? Part of the answer to these complex questions may be as simple as the food choices we make.
We can all develop allergies to the foods that we eat. In some people, these food allergies can trigger a significant inflammatory reaction in the kidneys causing either GN or NS. A prevalent example is an allergy to gluten, which is a common ingredient in many types of bread, including wheat and rye. A gluten allergy can cause an inflammatory process in your stomach and intestines called celiac disease. Having celiac disease increases your risk of developing any form of nephritis or nephrotic syndrome. There have been several cases reported of either NS or GN in people who had celiac disease. The advent of gluten free foods has been a blessing to those with this syndrome.
In another study, adults diagnosed with NS who ate a low allergy diet had a dramatic reduction in proteinuria. Moreover, in a study focusing on children who had been diagnosed with NS, there was a dramatic reduction in proteinuria when cow's milk was removed from the diet. And many of the children's urine protein levels remained low in follow-up. There are other reported cases where just by changing the nature of their diets, patients with other types of GN like IgA nephropathy were able to maintain kidney function and reduce proteinuria.
So what does this information suggest? It hints that there may be something in the food we are eating that is triggering nephritis or NS. But is it the preservatives, the food additives, or the coloring? Is the way the food is prepared? Or, is it a residual effect of how the farm animals are raised? Unfortunately, it isn't yet clear but hopefully will be sometime soon.
The information in these studies also suggests that one initial method of treating these conditions should be a low-allergy, inflammatory-free diet. It also suggests that figuring out what food allergies are present may be of benefit. Why certain people are more affected than others, however, remains a mystery.
Standard Treatment Approaches
The severity of kidney disease and the amount of protein in the urine will determine the degree of treatment. For those patients with mild disease - minimal proteinuria and normal or near-normal kidney function - your kidney doctor will likely monitor you closely. She will be asking you to obtain blood work on a routine basis to watch your kidney function, as well as for a urine test to follow your protein levels. In addition, she will prescribe either an ACE Inhibitor or ARB for its protein-reducing properties, and will closely follow your blood pressure and cholesterol levels. If you have significant edema, especially in your legs, your doctor may start you on a diuretic like furosemide (Lasix) to help with the swelling.
If your kidney function is abnormal or you are spilling a significant amount of protein in your urine, your doctor will likely talk with you about starting treatment with medications that can affect your immune system. This includes the use of medication such as prednisone, cyclosporine (Neoral, Sandimmune, or Gengraf), cyclophosphamide (Cytoxan), and mycophenolic acid (Cellcept). These medications are not without side effects. Some of them, including cyclosporine (Neoral, Sandimmune, or Gengrat) and myoophenolic acid (Cellcept), are also used for those who have undergone an organ transplant and need them to suppress their immune systems in order to prevent rejection. You need to speak with your kidney doctor at length regarding the benefits and risks of initiating such treatment. If your kidney function has been severely affected by the inflammatory process (GFR < 10 ml/min), you may also be asked to start dialysis. To find out more, you can check out Diagnosis Of Chronic Kidney Disease.