Kidney inflammation symptoms
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Kidney Inflammation Symptoms
Glomerular Hematuria and Kidney Inflammation
Glomerular Hematuria: One of the primary symptoms of kidney inflammation is glomerular hematuria, which can be classified as microhematuria or macrohematuria based on the number of red blood cells in the urine. Persistent glomerular microhematuria can contribute to the progression of renal disease, while macrohematuria can lead to acute kidney injury (AKI) and subsequent impairment of renal function. This condition can cause direct tubular cell injury, oxidative stress, and the production of pro-inflammatory cytokines, which further recruit monocytes and macrophages to the site of injury.
Chronic Inflammation in Chronic Kidney Disease (CKD)
Systemic Inflammation: In chronic kidney disease (CKD), inflammation becomes maladaptive, uncontrolled, and persistent. This chronic inflammation is a significant contributor to the uraemic phenotype, which includes cardiovascular disease, protein-energy wasting, depression, osteoporosis, and frailty. It is also a predictor of cardiovascular and total mortality. The inflammation in CKD is multifactorial, involving increased production and decreased clearance of pro-inflammatory cytokines, oxidative stress, acidosis, and chronic infections .
Leukocyte Accumulation and Chemokines
Leukocyte Accumulation: Kidney inflammation often involves the accumulation of leukocytes, which are attracted by specific chemokines. This process is crucial in conditions like glomerulonephritis (GN) and chronic kidney disease. The immune cell plasticity and the role of regulatory T lymphocytes in controlling inflammation are also significant aspects of renal inflammation.
Acute Kidney Injury (AKI) and Inflammation
Inflammatory Response in AKI: Acute kidney injury (AKI) is characterized by renal cell death through apoptosis or necrosis, accompanied by a strong inflammatory response. This inflammation can either contribute to the kidney injury or result from it. The kidneys have an intrinsic ability to regenerate after AKI, provided the damage is not too severe. However, repeated or severe episodes can lead to renal fibrosis and chronic kidney disease (CKD).
Role of Immune Cells in Renal Inflammation
Immune Cell Interactions: Inflammation in renal diseases involves a complex network of interactions between renal parenchymal cells and resident immune cells, such as macrophages and dendritic cells. These cells activate pathways like NF-κB and NLRP3 inflammasome, leading to the secretion of inflammatory mediators that cause tissue damage and functional loss. The gut microbiota also plays a role in influencing renal inflammation through its impact on oxidative stress and fibrosis.
Renal Fibrosis and Chronic Inflammation
Progressive Renal Fibrosis: Unresolved inflammation in the kidneys can lead to progressive renal fibrosis, which is a precursor to end-stage renal disease (ESRD). This process involves the production and release of profibrotic cytokines and growth factors by immune and renal cells. Macrophages, in particular, play a dual role in promoting both fibrosis and renal repair, depending on the context of the injury.
Conclusion
Kidney inflammation manifests through various symptoms and mechanisms, including glomerular hematuria, chronic systemic inflammation, leukocyte accumulation, and the complex interplay between immune cells and renal parenchymal cells. Understanding these processes is crucial for developing targeted therapies to manage and mitigate the progression of renal diseases.
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