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Nephropathy

Nephropathy

Overview
Nephropathy refers to damage to or disease of the kidney
Kidney
The kidneys are paired organs, which have the production of urine as their primary function. Kidneys are seen in many types of animals, including vertebrates and some invertebrates. They are part of the urinary system, but have several secondary functions concerned with homeostatic functions. ...

. An older term for this is nephrosis.

Causes of nephropathy include administration of analgesic
Analgesic
An analgesic is any member of the diverse group of drugs used to relieve pain . The word analgesic derives from Greek an- and algos...

s, xanthine oxidase deficiency, and long-term exposure to lead
Lead
Lead is a main-group element with symbol Pb and atomic number 82. Lead is a soft, malleable poor metal, also considered to be one of the heavy metals. Lead has a bluish-white color when freshly cut, but tarnishes to a dull grayish color when exposed to air...

 or its salts. Chronic conditions that can produce nephropathy include systemic lupus erythematosus
Systemic lupus erythematosus
Systemic lupus erythematosus is a chronic autoimmune connective tissue disease that can affect any part of the body...

, diabetes mellitus
Diabetes mellitus
Diabetes mellitus —often referred to simply as diabetes—is a condition in which the body either does not produce enough, or does not properly respond to, insulin, a hormone produced in the pancreas. Insulin enables cells to absorb glucose in order to turn it into energy...

 and high blood pressure (hypertension), which lead to diabetic nephropathy
Diabetic nephropathy
Diabetic nephropathy , also known as Kimmelstiel-Wilson syndrome and intercapillary glomerulonephritis, is a progressive kidney disease caused by angiopathy of capillaries in the kidney glomeruli. It is characterized by nephrotic syndrome and diffuse glomerulosclerosis...

 and hypertensive nephropathy
Hypertensive nephropathy
Hypertensive nephropathy is a medical condition referring to damage to the kidney due to chronic high blood pressure....

, respectively.

One cause of nephropathy is the long term usage of analgesics.
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Encyclopedia
Nephropathy refers to damage to or disease of the kidney
Kidney
The kidneys are paired organs, which have the production of urine as their primary function. Kidneys are seen in many types of animals, including vertebrates and some invertebrates. They are part of the urinary system, but have several secondary functions concerned with homeostatic functions. ...

. An older term for this is nephrosis.

Causes


Causes of nephropathy include administration of analgesic
Analgesic
An analgesic is any member of the diverse group of drugs used to relieve pain . The word analgesic derives from Greek an- and algos...

s, xanthine oxidase deficiency, and long-term exposure to lead
Lead
Lead is a main-group element with symbol Pb and atomic number 82. Lead is a soft, malleable poor metal, also considered to be one of the heavy metals. Lead has a bluish-white color when freshly cut, but tarnishes to a dull grayish color when exposed to air...

 or its salts. Chronic conditions that can produce nephropathy include systemic lupus erythematosus
Systemic lupus erythematosus
Systemic lupus erythematosus is a chronic autoimmune connective tissue disease that can affect any part of the body...

, diabetes mellitus
Diabetes mellitus
Diabetes mellitus —often referred to simply as diabetes—is a condition in which the body either does not produce enough, or does not properly respond to, insulin, a hormone produced in the pancreas. Insulin enables cells to absorb glucose in order to turn it into energy...

 and high blood pressure (hypertension), which lead to diabetic nephropathy
Diabetic nephropathy
Diabetic nephropathy , also known as Kimmelstiel-Wilson syndrome and intercapillary glomerulonephritis, is a progressive kidney disease caused by angiopathy of capillaries in the kidney glomeruli. It is characterized by nephrotic syndrome and diffuse glomerulosclerosis...

 and hypertensive nephropathy
Hypertensive nephropathy
Hypertensive nephropathy is a medical condition referring to damage to the kidney due to chronic high blood pressure....

, respectively.

Analgesics


One cause of nephropathy is the long term usage of analgesics. The pain medicines which can cause kidney problems include aspirin
Aspirin
Aspirin , also known as acetylsalicylic acid , is a salicylate drug, often used as an analgesic to relieve minor aches and pains, as an antipyretic to reduce fever, and as an anti-inflammatory medication....

, acetaminophen, and nonsteroidal anti-inflammatory drugs, or NSAIDs. This form of nephropathy is "chronic analgesic nephritis," a chronic inflammatory change characterized by loss and atrophy of tubules and interstitial fibrosis and inflammation (BRS Pathology, 2nd edition).

Specifically, long term use of the analgesic phenacetin
Phenacetin
Phenacetin is an analgesic, but its use has declined owing to its association with several adverse side effects, some of which are described in the following. Typical doses are 300mg to 500mg a day.-History:...

 has been linked to renal papillary necrosis
Renal papillary necrosis
Renal papillary necrosis is a form of nephropathy involving the necrosis of the renal papilla, which is supplied by the vasa recta.-Causes:Analgesic nephropathy is a cause of renal papillary necrosis. The damage is cumulative and most patients of renal papillary necrosis would have ingested at...

 (necrotizing papillitis).

Xanthine oxidase deficiency


A second possible cause of nephropathy is due to decreased function of xanthine oxidase
Xanthine oxidase
Xanthine oxidase is an enzyme that catalyzes the oxidation of hypoxanthine to xanthine and can further catalyze the oxidation of xanthine to uric acid...

 in the purine
Purine
A purine is a heterocyclic aromatic organic compound, consisting of a pyrimidine ring fused to an imidazole ring. Purines, including substituted purines and their tautomers, are the most widely distributed kind of nitrogen-containing heterocycle in nature....

 degradation pathway. Xanthine oxidase will degrade hypoxanthine
Hypoxanthine
Hypoxanthine is a naturally occurring purine derivative. It is occasionally found as a constituent of nucleic acids where it is present in the anticodon of tRNA in the form of its nucleoside inosine. It is also known as 6-Hydroxypurine. Hypoxanthine is a necessary additive in certain cell, bacteria...

 to xanthine
Xanthine
Xanthine , , is a purine base found in most human body tissues and fluids and in other organisms. A number of mild stimulants are derived from xanthine, including caffeine and theobromine....

 and then to uric acid
Uric acid
Uric acid is an organic compound of carbon, nitrogen, oxygen and hydrogen with the formula C5H4N4O3.-Biology:...

. Xanthine is not very soluble in water; therefore, an increase in xanthine forms crystals (which can lead to kidney stone
Kidney stone
Kidney stones or renal calculi are solid concretions or calculi formed in the kidneys from dissolved urinary minerals. Nephrolithiasis refers to the condition of having kidney stones...

s) and result in damage of the kidney. Drugs like allopurinol
Allopurinol
Allopurinol is a drug used primarily to treat hyperuricemia and its complications, including chronic gout.- Mechanism of action :...

 that are used to inhibit xanthine oxidase can therefore cause possible nephropathy.

See also

  • Hematologic Diseases Information Service
    Hematologic Diseases Information Service
    The Hematologic Diseases Information Service is an information dissemination service of the National Institute of Diabetes and Digestive and Kidney Diseases . The NIDDK is part of the National Institutes of Health, which is part of the U.S. Department of Health and Human Services...

  • Nephritis
    Nephritis
    Nephritis is inflammation of the kidney. The word comes from the Greek nephro- meaning "of the kidney" and -itis meaning "inflammation". Nephritis is often caused by infections, toxins, and auto-immune diseases.-Subtypes:...

  • IgA nephropathy
    IgA nephropathy
    IgA nephropathy is a form of glomerulonephritis...

  • Protein toxicity
    Protein toxicity
    Protein toxicity with proteinuria can result in those with preexisting kidney disease, or those who have lost kidney function due to age. Consuming more than 2.0 g/kg/day in protein can stress the kidney even in otherwise healthy people.- Symptoms :...