Nephritis

Nephritis is the inflammation of one or both kidneys. Nephritis may involves the glomerulus, tubule or the interstitial renal tissue. It can be caused by infection or toxins but is most commonly caused by an autoimmune disorder that affects the major organs.

Case 1

Date 23/06/2007

Patient: Male, age 67 yrs old

Clinical history: On 13/03/2006, the patient was admitted to the hospital where a renal biopsy was conducted. Light microscopy revealed : 1) 34 glomeruli with one obsolescent; 2) mild focal segmental endothelium proliferation and vacuolar degeneration on the glomerular basement membrane; 3) swelling of some epithelium; 4) mild proliferation of mesangium and mesangial matrix; 5) atrophy of few tubular and the present of albumin casts within tubular 6) interstitial fibrosis; 7) the present of Neutrophils within the few of glomerular capillary lumina; 8) the presence of addicted fuchsin protein deposit in the mesangial area, subendothelial and epithelial; 9) slightly intimal thickening of interlobular arteries. Immunofluorescent microscopy examination revealed the presence of granular deposits of IgG (++), IgM(++), IgA(+), C3(+) along the capillary. The pathological diagnosis: 1) Hepatitis B virus associated glomerulonephristis. HBV-GN; 2) Hepatitis B carrier; 3) Atherosclerosis; 4) benign prostatic hypertrophy; 5) Nodular goitre

In hospital, the patient was treated with Prednisone (40mg/daily at start and tapering down) in conjunction with Mycophenolate mofetil ( 0.75g per 2/day). At the time, urinalysis showed urine protein excretion 1.5g/24hr. Urine microscopy showed RBC42.2mg/ul. The laboratory tests showed:

TP 38g/dL ( 60 -80 )

ALB 22.8g/dL ( 35 – 55 )

GLB 15.2/dL ( 20 – 30 )

CHOL 4.14mmonl/L ( 2.4 – 5.5 )

BUN and creatinine were normal . The patient was discharged from the hospital on 04/04/2006, but continued the same treatment as outpatient . On 19/04/2007, the patient’s laboratory tests showed TP 41.0g/L, ALB 21.6g/L, CHOL 5.57 mmol/L., urinalysis showed urine protein excretion 7.0g/24hr, urine microscopy showed RBC38.6/ul. The results indicated that there was no improvement under the steroids and Mycophenolate mofetil combination.

The patient started our TCM remedy therapy on 23/06/2007, after one year of treatment, he was free of steroids, his urine analysis showed that urine protein excretion had decreased to 0.26/24hr, no trace of RBC, and his laboratory tests showed TP had increased to 61.0g/L, ALB increased to 41.3g/dL (within normal range), CHOL decreased to 4.78mmonl/L. He continued the TCM remedies for one more year. In February 2010, his urinalysis showed that his urine protein excretion had decreased to 0.12g/24hr, no trace of RBC under the urine microscopy, his laboratory tests showed the TP had increased to 66.9g/dL, ALB increased to 44.2g/dL, CHOL decreased to 4.2mmonl/L. Today the patient remains free of proteinuria and hematuria.

Case 2

Date: 18/06/1997

Patient: Female, age 33 yrs old

Clinical history: On 07/05/1996, the renal nuclear renogram indicated severely impaired renal function of both kidneys.

On 09/05/1996 a biopsy was conducted on the right kidney, the biopsy specimen showed 10 glomeruli fibrosis out of 21 glomeruli detected in the specimen ; the other 11 glomerular had no changes in glomerular endocapillary, tubulointerstitial became fibrosis, and most part of tubular also became fibrosis. Pathological diagnosis: chronic pyelonephritis.

Biopsy Immunofluorescence microscopy examination revealed the presence of IgG deposits in the glomerular basement membrane, some glomeruli became fibrosis, and the present of protein casts within the tubules. Staining for C3 were negative.

On 18/06/1997, the patient came to our clinic to seek alternative treatment, at that time she was on steroids 30mg/day, her serum creatinine was >500 μmol/l, hemoglobin was 6g/L. Her 24 hour urine output was between 100 and 200ml. She was on peritoneal dialysis for just over 1 month.

After 12 days of starting our therapy, the patient’s urine output had increased to 400-500ml per day. After one month, the patient stopped peritoneal dialysis, she continued our TCM remedy therapy for another 4 years, during this period her condition remained stable.

Case 3

Date: Jan 2004

Patient: Female, 25 yrs old

Clinical history: The patient was diagnosed as Pyelonephritis over 1 1/2 years prior to coming to our clinic. She was under the conventional treatment with antibiotics and anti-inflammatory drugs. However, at the end of each course of the treatment she suffered a relapse.

In January 2004, she commenced an period of our TCM remedy therapy for 8 months; she is presently free of the disease and has suffered no further relapse.