Glomerulonephritis – what is it, causes, signs,acute symptoms and treatment

Glomerulonephritis is a bilateral inflammatory
pathology of the kidneys, accompanied by the defeat of small renal
vessels. With the development of this disease is a violation
The main work of this body: the formation of urine, cleansing
organism from both toxic and unnecessary substances.

What is this disease, what are the causes of its development and the main
symptoms and what is prescribed as a treatment for people with
гломерулонефритом, и какую диету соблюдать, рассмотрим
Further.

Glomerulonephritis: what is it?

Гломерулонефрит

Glomerulonephritis is a group of kidney diseases that have
various clinical manifestations. However, with all the diversity
symptoms, the result of untreated glomerulonephritis one: gradual
or rapid formation of renal failure with possible
development of uremic coma.

In most cases, the development is due to excessive immune
the body’s response to antigens of an infectious nature. Exists
also an autoimmune form of glomeruralonephritis, in which the lesion
kidney occurs as a result of the devastating effects
autoantibodies (antibodies to the cells of their own body).

The disease has the following distinguishing features:

  • characterized by the defeat of the glomeruli and tubules;
  • has an immunoinflammatory origin;
  • steadily progressing;
  • leads to the development of secondary arterial hypertension;
  • affects mostly young people;
  • not treated with antibiotics alone;
  • proceeds in acute and chronic forms.

Classification

According to the mechanism of development, there are:

  • primary glomerulonephritis – pathology in this case is allocated
    as an independent disease;
  • secondary type – the disease under consideration is accompanied by
    other systemic pathologies (lupus erythematosus, rheumatoid arthritis
    species and others).

Острый гломерулонефрит почек

Acute glomerulonephritis – occurs for the first time and always
suddenly
recovery, but may become chronic.

This pathology is peculiar to children from 2 to 12 years old and adults.
to 40. Men are somewhat more prone. Humidity and cold
contribute to his outbreaks. Infections like pharyngitis and tonsillitis, and
scarlet fever and erysipelas of the skin lead to complications
on the kidneys.

Subacute (malignant) – progresses rapidly and is very bad
treatable with special remedies. 80% of cases
end lethal.

Chronic course

Хроническое течение — бессимптомное начало болезни, нередко
pathological changes are detected when already developed
renal failure. Long developing pathology
leads to the replacement of nephrons with connective tissue.

The following variants of the course of chronic
glomerulonephritis:

  • nephrotic (urinary symptoms prevail);
  • hypertensive (marked increase in blood pressure,
    urinary syndrome is mild;);
  • mixed (combination of hypertonic and nephrotic
    syndromes);
  • latent (fairly common form, characterized by
    lack of edema and arterial
  • hypertension with mild nephrotic syndrome);
  • hematuric (the presence of red blood cells in the urine,
    the remaining symptoms are absent or mild).

For all forms of glomerulonephritis recurrent
flow. Clinical symptoms of exacerbation resemble or completely
repeat the first episode of acute glomerulonephritis.

The reasons

Causes of the disease are previous infections –
стрептококковая, стафилококковая и иные бактериальные infections. AT
some cases of etiological factor in the development of the disease
могут выступать гепатиты AT и С, и возможно цитомегаловирусная
infection.

Glomerulonephritis can develop on the background of diseases
parasitic nature, under the toxic effects of some
drugs, when using alcohol and drugs, especially strong
influence these habits have in adolescence.

Microorganisms play a special role, and this does not concern
not only previously allocated streptococcus, but also staphylococcus,
Plasmodium malaria and some other types of viruses. More often
just as the causes of the development of the disease are such
diseases like:

  • scarlet fever,
  • sore throats
  • pneumonia,
  • streptoderma (purulent-type skin lesions).

Also as contributing factors
glomerulonephritis can be identified:

  • ОРATИ,
  • chicken pox,
  • measles.

In other words, infectious exposure factor is one of
the main ones.

Risk factors:

  • genetic predisposition;
  • foci of chronic infection;
  • hypovitaminosis;
  • systemic diseases (lupus erythematosus, vasculitis);
  • hypothermia;
  • poisoning by toxic substances (alcohol, mercury,
    lead);
  • vaccination and blood transfusion;
  • radiation therapy.

Symptoms of glomerulonephritis in adults

Symptoms of acute diffuse glomerulonephritis appear later.
one to three weeks after an infectious disease, usually caused by
streptococci (angina, pyoderma, tonsillitis). For acute
glomerulonephritis is characterized by three main groups symptoms:

  • urinary (oliguria, micro- or gross hematuria);
  • hydropic;
  • hypertensive.

The first symptoms of glomerulonephritis:

  • temperature increase
  • chills,
  • fatigue
  • loss of appetite
  • pain in the lumbar region,
  • pallor of the skin and puffiness of the eyelids.

Characterized by a decrease in diuresis within five days after the onset
diseases. After that, the volume of urine may increase again, however
relative density will be significantly reduced.

Mandatory laboratory symptom of glomerulonephritis – hematuria.
Both microhematuria and gross hematuria are possible, in which
the color of urine changes – it becomes dark brown.

To the specific signs of acute glomerulonephritis
relate:

  • swelling – they can be peripheral and frontal,
    some patients may develop internal edema (ascites);
  • increased blood pressure – this symptom is noted even
    those who have never noticed any disruption
    of cardio-vascular system;
  • changes in the process of urination – urine becomes “color
    meat slop “due to the presence of blood in it, becomes muddy
    due to protein, oligonuria (scanty
    urination).

As well as acute glomerulonephritis, chronic can occur
practically asymptomatic. The latent form is characterized only
weak violation of urine.

With kidney damage often develops hypertensive syndrome.
It is characterized by increased blood pressure. It’s hard
amenable to correction with the help of drugs. pressure in
such patients exceeds 140/90 mm Hg. Art. At the heart of the development of this
syndrome most play the following disorders:

  • activation of the renin-angiotensin system;
  • water retention;
  • an increase in BCC (circulating blood volume);
  • impaired production of prostaglandins A and E;
  • sodium retention.

In addition to these features, acute glomerulonephritis also
can occur in two forms, being:

  1. cyclic (which characterizes its rapid beginning)
  2. latent (with the beginning of a gradual). Latent form
    diagnosed in frequent cases, and it is the diagnosis that plays here
    the key role because excluding it as such leads to
    transition to chronic disease.

With the diagnosis of chronic glomerulonephritis symptoms and treatment
somewhat different. Pathology itself is restrained, health
the patient does not suffer from remission. When aggravation occurs,
There are all signs of the acute form listed above.

For all forms of chronic glomerular nephritis characteristic
periodic relapses. Their clinical manifestations resemble or
acute glomerulonephritis is repeated. More frequent exacerbations occur in
autumn-spring period when streptococcal activates
infections.

Complications

Acute diffuse glomerulonephritis can lead to development
the following complications:

  • острая почечная недостаточность (около 1% случаев);
  • острая сердечная недостаточность (менее 3% случаев);
  • преэклампсия или эклампсия (острая почечная
    hypertensive encephalopathy);
  • intracerebral hemorrhage;
  • transient visual disturbances;
  • chronic diffuse glomerulonephritis.

The risk of complications increases with incorrect or
delayed therapy. Asymptomatic glomerulonephritis,
which is often observed in adulthood, can lead to
serious consequences.

Therefore, it is important to correctly and promptly treat provoking
processes, pass tests and control basic laboratory
indicators that may vary with glomerulonephritis.

Diagnostics

At the reception at the nephrologist, the patient must describe all
свои жалобы в подробностях, а врач будет
выслушивать симптомы гломерулонефрита и делать выводы о
the need for additional diagnostics, further strategy
treatment. Обязательно нужно сказать лечащему врачу о таких
malaise:

  • headache;
  • severe fever;
  • nausea, occasionally vomiting;
  • weakness and drowsiness.

Among the main methods of diagnosis of this pathology can
include:

  1. Ocular fundus. It makes it possible to identify the degree of vascular lesions.
    retina.
  2. Общий анализ мочи. In the case of this pathology in
    urine of patients can detect both leukocytes, protein, erythrocytes,
    as well as cylinders.
  3. Ultrasound examination (ultrasound) of the kidneys allows
    reveal an increase in their size in the case of acute glomerulonephritis and
    shrinkage if the person has a chronic form
    this pathology or renal failure.
  4. A biopsy of the kidney makes it possible to determine the form of this
    pathology, as well as its activity. In addition, this method
    research helps eliminate the presence of other kidney afflictions, while
    which have the same symptoms.
  5. Серологический анализ крови. With it, you can identify
    increase in antibodies to streptococcus in the blood.

Treatment гломерулонефрита почек

Treatment of the acute form of the disease is made during hospitalization.
patient (therapeutic or nephrology department). Before
all, patients are assigned bed rest, as well as
Diet-Specific Diet (No. 7).

Treatment Glomerulonephritis consists of:

  • Strict bed rest.
  • Antibacterial, antiviral treatment (for infectious
    nature of the disease).
  • Symptomatic agents (diuretics, hypotensive,
    antihistamines).
  • Immunosuppressive treatment (cytostatics).
  • Dialysis – an artificial kidney connection to the device (with
    rapid development of renal failure).

Drug treatment includes:

  • antibiotic therapy, antibiotics are most often prescribed
    penicillin series 1.5-2 months.
  • Recommended the appointment of heparin subcutaneously course of 2-4 weeks.
    The drug prevents intravascular coagulation.
  • If the symptoms of glomerulonephritis include arterial
    ACE inhibitors are prescribed for hypertension, intravenous fluids
    aminophylline in glucose solution and subsequent infusion
    furosemide.
  • Allowed the use of clonidine, methyldopa.

После того, как острая фаза будет купирована, лечение
гломерулонефрита продолжают приемом антигистаминных
drugs, to them the doctor adds anticoagulants to improve
blood circulation. If the patient’s condition is severe,
назначены цитостатики и гормональные средства.

Treatment разных видов:

  • Latent form of glomerulonephritis. Active immunosuppressive
    therapy is not indicated. При протеинурии >1,5 г/сут назначают
    ACE inhibitors.
  • Hematuric form. The intermittent effect of prednisone and
    cytostatics. Patients with isolated hematuria and / or small
    proteinuria – ACE inhibitors and dipyridamole.
  • Hypertensive. ACE inhibitors; target level of blood pressure –
    120-125/80 мм рт.Art. For exacerbations cytostatics are used in
    part of the 3-component scheme. Glucocorticoids (Prednisone 0.5
    mg / kg / day) can be administered as monotherapy or as part of
    combined schemes.
  • Nephrotic form of glomerulonephritis – indication for purpose
    3 or 4 component scheme
  • Смешанная форма — 3- или 4-компонентная схема treatment.

The successful outcome of the treatment of glomerulonephritis depends on
what stage of the disease it was started. The earlier diagnosed
pathology, the more effective the therapy will be. Even after complete
recovery the patient needs a long time to be under
follow up by a nephrologist and monitor the condition
the kidneys.

Diet

For the treatment of glomerulonephritis, the doctor prescribes medications,
physiotherapy, salt-free diet – medical table number 7. She is:

  • promotes urination;
  • is antiallergic;
  • improves metabolic processes in the renal tissue.

Permitted Products

Food for glomerulonephritis should consist of:

  • sour milk;
  • as many fruits and vegetables as possible;
  • lean fish and meat;
  • croup;
  • boiled eggs;
  • fresh juices, fruit compotes and fruit drinks;
  • vegetable oils.

There are a number of products that can adversely affect
on the course of the disease and lead to its aggravation by causing renal
failure. Patients are strictly not recommended to use
The following during a diet for glomerulonephritis:

  • fatty;
  • smoked
  • canned;
  • spicy
  • salty;
  • alcohol.

Day menu for glomerulonephritis

1st breakfast
  • Cottage cheese,
  • buckwheat,
  • egg,
  • sweet tea or coffee (if there is no hypertension) with milk.
2nd breakfast
  • Pasta,
  • fruit salad,
  • milk soup,
  • the juice,
  • decoction of wild rose.
Dinner
  • Vegetable or cereal soup,
  • vegetarian soup,
  • boiled lean meat (rabbit, poultry),
  • cabbage, porridge,
  • potatoes (better boiled in the peel),
  • fruit and vegetable salads.
Afternoon tea
  • Fruits,
  • соки, кефир, молоко,
  • carrot cutlets
  • baked apples,
  • baked potato,
  • buns, cheesecakes, biscuits.
Dinner
  • Pasta,
  • mashed potatoes,
  • rice porridge with fruit,
  • baked potato,
  • weak sweet tea, juices.
For the night
  • Kissel,
  • fruit salad.

Prevention

Events for the primary prevention of development of the process
pathologies include:

  • moderate hardening;
  • low sensitivity to low temperatures;
  • adequate elimination of chronic infectious foci.

When any symptoms are characteristic of glomerulonephritis,
Be sure to contact a nephrologist for treatment. Watch your
health and on time pass diagnostics.

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