occult glomerulonephritis
Introduction
Introduction to occult glomerulonephritis Occult glomerulonephritis, also known as asymptomatic hematuria or (and) proteinuria, a group of patients with edema, hypertension, and impaired renal function, but only glomerular hematuria or (and) proteinuria Glomerular disease. Acute glomerulonephritis, referred to as acute nephritis, is a group of clinical syndrome characterized by acute onset, hematuria, proteinuria, hypertension, edema, oliguria, and renal dysfunction, also known as acute nephritic syndrome. Its onset often occurs in infections, mainly after streptococcal infection, which is an immune complex nephritis. basic knowledge The proportion of illness: 0.005%--0.007% Susceptible people: no specific population Mode of infection: non-infectious Complications: high blood pressure
Cause
The cause of occult glomerulonephritis
Eating is not good (30%)
Over-eating fat, spicy and thick taste, damage to the spleen and stomach, transporting dereliction of duty, endogenous damp heat, betting of the bladder, resulting in the bladder can not distinguish between turbidity and proteinuria and hematuria. If the food is not enough, the blood and blood are biochemically passive, and the body is not supplemented with nutrients, which affects the function of the organs, leading to proteinuria and hematuria.
Work tired and hurt the spleen (20%)
Long-term accumulation of disease, injury in the coke, spleen lost, on the one hand, qi and blood biochemical passive, on the other hand can metaplaose damp heat, leading to imaginary evil, visceral dysfunction and proteinuria and hematuria.
Congenital deficiency (10%)
Insufficient congenital endowment, acquired loss of nursed back to health, low visceral function, especially spleen and kidney function failure, can not take the fine substance and vent, causing proteinuria and hematuria.
House labor injury kidney (10%)
Excessive labor, labor desire to hurt the kidney, kidney essence deficiency, kidney deficiency, can not distinguish between turbidity, subtle substances leaking and cause proteinuria and hematuria.
Seven emotions stagnation (10%)
Excessive thinking, sorrowful grief, damage to the spleen and stomach, spleen loses health, no power to control, then subtle substance discharge; liver qi stagnation, poor blood flow, blood stasis, damage to blood, blood and micro-material leakage, Proteinuria and hematuria can occur.
Feel the evil (10%)
Inadvertent living, nourishment, feeling exogenous, or warm, or heat evil. Damp heat or heat evils under the coke, damage the bladder function, or damage the yin, can lead to proteinuria and hematuria.
Prevention
Occult glomerulonephritis prevention
Active treatment of high blood pressure, excessive blood pressure can destroy the function of the kidney to regulate blood pressure, increase the pressure inside the glomerulus, cause kidney damage, actively treat the primary disease, control systemic lupus erythematosus, rheumatoid arthritis, dermatomyositis, etc. Rheumatoid diseases and diabetes, etc., the combination of traditional Chinese and Western medicine for the treatment of primary disease is reliable.
Regular professional hospitals for medical treatment, when the body is unwell, you can go to the regular hospital for urine routine and renal function tests, generally can detect the changes in the condition in time, after the kidney disease, should be used under the guidance of a professional doctor.
In short, the kidney is a delicate organ of our body, and we need to take good care of it to keep the vitality of the "innate".
Complication
Occult glomerulonephritis complications Complications
The prognosis of occult glomerular disease is good, and the long course of disease can last for decades, while renal function can be no significant damage.
Symptom
Occult glomerular nephritis symptoms common symptoms back acid protein urine hematuria
First, medical history and symptoms
Most patients have no clinical symptoms. Only urine examination abnormalities are found during physical examination. A few may have gross hematuria, but no edema, high blood pressure, may have acidosis in the waist, increase after exertion or infection, and can be alleviated after treatment.
Second, physical examination found
There were no positive signs in the examination.
Third, auxiliary inspection
24-hour urine protein is more than 2g, mostly albumin, most of the microscopic hematuria, red blood cells are pleomorphic, diversity, normal renal function, rheumatoid factor and anti-nuclear antibody negative, normal complement, isotope Kidney, kidney B ultrasound and intravenous pyelography were normal.
Examine
Occult glomerulonephritis
Characteristics of abnormal urine changes in this disease:
1 only a small amount of proteinuria, often referred to as "asymptomatic proteinuria."
2 repeated episodes of hematuria, patients usually have no abnormal urine test or only microscopic hematuria, no special symptoms and signs, under the influence of certain incentives (such as fever, pharyngitis, fatigue, cold), after several hours or days (more than 1 -2 days), gross hematuria occurred, short-term (via 1-4 days) hematuria disappeared or returned to the original level, such as microscopic hematuria persisted, phase contrast microscopy of urinary red blood cells is polymorphic, count > 10000 / ml, no The tube type can be called "simple hematuria".
24-hour urine protein is more than 2g, mostly albumin, most of the microscopic hematuria, red blood cells are pleomorphic, diversity, normal renal function, rheumatoid factor and anti-nuclear antibody negative, normal complement, isotope Kidney, kidney B ultrasound and intravenous pyelography were normal.
Diagnosis
Diagnosis and diagnosis of occult glomerulonephritis
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory findings.
Differential diagnosis
Clinical manifestations of "asymptomatic proteinuria" or "simple hematuria", no previous acute, chronic nephritis or kidney disease history, no edema, hypertension, dysfunction, blood biochemistry, no change, the diagnosis is basically established, but need to The following physiological proteinuria and the like were identified.
First, functional proteinuria hyperthermia, due to renal vasospasm or decreased pH after violent physical activity, the glomerular vessel wall permeability is enhanced, can cause proteinuria, but disappear after removal of the cause, after strenuous exercise, some patients There is macroscopic or microscopic hematuria, but disappears shortly after stopping the exercise.
Second, about 5% of adolescents with orthostatic proteinuria, apparent proteinuria when standing upright, generally without microscopic hematuria, disappearance of urine protein in the supine position, the exact mechanism of orthostatic proteinuria is still unclear, some orthotopic proteinuria The glomerulus has abnormal changes.
Third, IgA nephropathy clinically with recurrent hematuria as the main performance, often due to upper respiratory tract infection or fatigue, after a few hours to a few days after the cold (mostly 1-2 days) caused by hematuria or gross hematuria, the cause of elimination, the naked eye Hematuria also disappeared, and returned to the original level, no edema, no hypertension, no blood biochemistry and renal dysfunction, only a small number of patients can be manifested as acute nephritis syndrome, hypertension, and eventually developed into renal dysfunction, but the diagnosis remains Renal biopsy tissue examination (IgA is widely deposited in the glomerular mesangial area).
Fourth, pay attention to the identification of urinary tuberculosis, stones, tumors.
