Symptoms of chronic interstitial nephritis

The incidence of stones in chronic interstitial nephritis is relatively high, which can cause many adverse effects on patients, often showing adverse symptoms such as fatigue, anorexia, nausea, vomiting, anemia, etc. Therefore, it is necessary to identify these symptoms and treat them symptomatically.

1. Chronic interstitial nephritis often has an insidious onset and can also be a continuation of acute interstitial nephritis. Its common clinical manifestations: Some cases may have no symptoms. Anemia, hypertension and mild changes in urine routine tests are often found during physical examinations or when visiting the doctor for other diseases. In severe cases, renal dysfunction and renal osteodystrophy may be found. Urine examination often shows mild proteinuria (often mainly low-molecular proteinuria), with a small amount of white blood cells in the urine sediment, and occasionally red blood cells and casts.

2. Renal tubular function damage occurs in the early stages of the disease. When the glomerular filtration rate (GFR) is normal or only slightly reduced, increased nocturia, low specific gravity urine, and decreased urine osmotic pressure may occur. Sometimes symptoms such as polydipsia and polyuria may also occur. Impaired bicarbonate absorption in the proximal tubules or impaired uric acidification in the distal tubules can cause hyperchloremic metabolic acidosis, also known as renal tubular acidosis. The proximal renal tubular function is impaired, resulting in decreased reabsorption and increased excretion of bicarbonate, sugar, uric acid, phosphate, and amino acids, manifesting as Fanconi syndrome. Partial distal tubular dysfunction causes salt loss and potassium storage. In severe cases, volume depletion and/or hyperkalemia may occur.

3. In the late stage of renal insufficiency, symptoms such as fatigue, anorexia, nausea, vomiting, and anemia may occur. The anemia is often severe and does not correspond to the degree of renal function impairment. More than half of the patients may develop hypertension. When some patients develop acute renal papillary necrosis, they often experience chills, high fever, gross hematuria, and low back pain, and necrotic tissue fragments can be found in the urine sediment.