Tuesday, 3 December 2013

Nephritis: Interstitial nephritis (Tubulo-interstitial nephritis) - The Treatments

Nephritis is defined as a condition of inflammation of the nephrons in the kidneys.
Interstitial nephritis (Tubulo-interstitial nephritis) 
Interstitial nephritis is defined as a condition of inflammation of the spaces between renal tubules, affecting the interstitium of the kidneys and kidney function in wast removal.

F.1. In conventional medicine perspective
1. Acute tubulointerstitial nephritis
In the study to evaluate the controversial effects of steroids in acute tubulointerstitial nephritis (ATIN), showed that steroid treated (StG) patients had a greater degree of improvement in their renal function; however there was no correlation between the degree of improvement in eGFR and delay in starting steroids. PPIs were second commonest implicated drug category among drug induced cases(13).

2. Chronic tubulointerstitial nephritis
Chronic tubulointerstitial nephritis has no cure. Many patients may require dialysis. In younger patient,  kidney transplant may be the only choice. 

F.2. In herbal medicine perspective
1. Soy
In the study to evaluate the effects of soy protein isolate (SPI) on severe kidney damage in deoxycorticosterone acetate (DOCA) salt-treated obese Zucker rats, researchers at the Food Science Research Institute, Fuji Oil Company Ltd., Izumisano-shi, showed that that consecutive treatment of SPI protects against renal dysfunction, particularly tubulointerstitial nephritis, in DOCA salt-treated obese Zucker rats(14).

2.  Flaxseed
In the study to determine if flaxseed would also modify clinical course and renal pathology in the Han:SPRD-cy rat, showed that Flaxseed ameliorates Han:SPRD-cy rat polycystic kidney disease through moderation of the associated chronic interstitial nephritis. The diet alters renal content of polyunsaturated fatty acids in a manner that may promote the formation of less inflammatory classes of renal prostanoids(15).

3. Etc.
F.3. In traditional Chinese medicine perspective 
1. Traditional Chinese medicine with immunosuppressant
In an  experimental study combined on traditional Chinese medicine with immunosuppressant for treatment and prevention of tubular interstitial nephritism researchers at the Department of Nephrology, First Affiliated Hospital, showed that the infiltration of cells was inhibited in the "Chinese herbs combined with prednisone" group, the infiltration of cells, TGF-beta expression and interstitial fibrosis were all inhibited in the cyclophosphamide and prednisone" group. But in the prednisone group, interstitial fibrosis was not inhibited. These data suggest that the combined use of Chinese herbs, immunosuppressant and prednisone can inhibit the interstitial cell infiltration and prevent the interstitial fibrosis in diffuse proliferative glomerulonephritis(16).

2. Astragali Radix and Angelicae Sinensis Radix (AS-IV)with ferulic acid
Other researchers suggested that AS-IV synergizes with FA to alleviate renal tubulointerstitial fibrosis; this was associated with inhibition of tubular epithelial-mesenchymal transdifferentiation (EMT) and fibroblast activation, as well as an increase in NO production in the kidney(17).

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(12) http://www.ncbi.nlm.nih.gov/pubmed/14655203
(13) http://www.ncbi.nlm.nih.gov/pubmed/22817666
(14) http://www.ncbi.nlm.nih.gov/pubmed/22553937 
(15) http://www.ncbi.nlm.nih.gov/pubmed/9987066
(16) http://www.ncbi.nlm.nih.gov/pubmed/12515139 
(17) http://www.ncbi.nlm.nih.gov/pubmed/21232035  

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