Bright's disease is an obsolete classification for nephritis, a kidney condition. It was named after Dr. Richard Bright, who described the condition in the early 19th century. A lack of understanding of how the kidneys work at the time meant that the conditions now known as chronic and acute nephritis were both considered Bright's disease. Though this condition is usually treatable, it can cause long-term, serious complications.
Both types of nephritis are caused by inflammation of part of the kidneys, usually either the glomeruli or the spaces in between the renal tubules. The first is the part of the kidneys that filter blood, and the second are the areas in between the parts of the kidneys that collect the fluid after it's filtered by the glomeruli. The inflammation can be caused by many different conditions, including lupus, a urinary tract infection that travels up to the kidneys, bacterial infections, and allergies to certain medications. Infectious diseases like pneumonia, measles, mononucleosis, and hepatitis, can also cause Bright's disease, as can having too little potassium or too much calcium in the blood. Additionally, using Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) in high dosages over a long period of time can cause kidney inflammation.
Those symptoms most commonly associated with Bright's disease are intense pain on either or both sides of the lower back along with a fever and nausea. Cloudy, dark, or bloody urine containing blood plasma proteins is also a hallmark sign of kidney problems. In those with kidney failure caused by high blood pressure, swollen extremities caused by the retention of fluids is also common. If the kidneys fail and cause fluid to accumulate in the lungs or if a cancer in the kidneys spreads to the lungs, then a person may have trouble breathing.
Historical and Modern Treatments
Historically, Bright's disease was treated with diuretics and laxatives, as well as bloodletting in extreme cases. In modern times, kidney inflammation is treated according to the underlying cause. For instance, if a person has nephritis from NSAID overuse, then stopping the use of NSAIDs can usually significantly reduce inflammation. The restriction of salt, protein, and fluids can also usually help with this condition, particularly in those with high blood pressure. If there's an underlying infection, like a urinary tract infection or pneumonia, then treating that condition with antibiotics or antivirals can also help. In severe cases, dialysis may be needed.
Bright's disease has a pretty good prognosis when treated promptly, but some people do develop complications. Perhaps the most common complication is nephritic syndrome, in which proteins and red blood cells leak into the urine through holes in certain cells in the glomeruli. If the kidneys don't function correctly for a long time, then a person can also develop metabolic acidosis, in which the body has too much acid, since the kidneys don't remove it properly. Though it's rare, some people do go into full blown kidney failure or develop end-stage kidney disease, which means they have to go on dialysis permanently or get a new kidney.