Anka's nephritis
Introduction
Introduction to Anka Nephritis Anka nephritis is mainly caused by ANCA-associated vasculitis, which is characterized by hypothermia, fatigue, joint pain, etc. The renal pathology is reflected in proteinuria, hematuria, edema, and severe cases may have hypertension and kidney. Depletion, etc., the pathological manifestations of the lungs are cough, hemoptysis, severe respiratory infections, etc., because ANCA-associated vasculitis is a systemic autoimmune disease that can affect multiple organs throughout the body, led by the kidneys. basic knowledge Sickness ratio: 0.1% Susceptible people: no specific population Mode of infection: non-infectious Complications: anemia, high blood pressure
Cause
The cause of Anka nephritis
First, the cause of damage to the blood tubule:
The occurrence of primary vasculitis is mainly caused by immune abnormalities, while the research is more humoral immunity, and less research on cellular immunity. It is sensitized both endogenous and exogenous, with nuclear antigen, cryoglobulin and denaturing immunoglobulin in the endogenous; multi-drug and infectious factors in the exogenous antigen, neutral Granulocytes can be stimulated by a series of pro-inflammatory molecules such as IL-1, TNF, TGF-, LPS, etc., and are in a preliminary activation state, resulting in specific target antigens such as protease 3 and myeloperoxidase in the cytoplasmic ANCA. It can be expressed on the cell surface. The binding of ANCA in the serum to the corresponding antigen can ultimately activate neutrophils to cause degranulation, generate oxygen free radicals and release proteases to cause damage to the vascular endothelium.
Second, the reasons for the kidneys are involved:
Because ANCA damages most of the small and medium-sized blood vessels in the human body, it causes systemic immune function damage, which is manifested as systemic diffuse disease. In many diseases, due to the large number of blood tubules in the kidney, the kidney suffers the most damage. . Renal biopsy pathological examination showed that the early stage of renal involvement was characterized by focal segmental glomerular capillary necrosis, and the disease was progressive or the kidney damage was more severe when it was characterized by crescentic nephritis. The degree of deterioration is related to the extent and size of the formation of the crescent. Renal interstitial typical small arterial cell necrosis is rare, and renal medullary leukocyte fragmentation vasculitis is not common, so the clinical manifestations of primary vasculitis are diverse and can easily lead to misdiagnosis.
Prevention
Anka nephritis prevention
First, control the diet structure, avoid excessive intake of acidic substances, and exacerbate acidic constitution. The acid-base balance of diet is a very important part of the treatment of diabetes and the prevention and treatment of complications. For food, eat more foods rich in plant organic active base, eat less meat, and eat more vegetables.
Second, participate in aerobic exercise, exercise properly, exercise more sweat in the sun, help eliminate excess acidic substances in the body, thus preventing the occurrence of kidney disease.
Third, maintain a good mood, do not have excessive psychological pressure, excessive pressure will lead to the deposition of acidic substances, affecting the normal conduct of metabolism. Proper adjustment of mood and self-stress can maintain a weak alkaline constitution, thereby preventing the occurrence of kidney disease.
Fourth, people who have regular life and irregular living habits, such as singing karaoke, playing mahjong, and not returning home at night, will have aggravated physical acidification.
Fifth, stay away from smoke and alcohol. Smoke and alcohol are typical acidic foods. Uncontrolled smoking and drinking can easily lead to acidification of the human body, making kidney disease organic. In daily life, in addition to preventing and improving the treatment of nephritis, tea can also regulate the balance of body mechanism, anti-inflammatory and antibacterial, clearing away heat and detoxifying, and enhancing human body resistance. Such Chinese herbal teas mainly include honeysuckle, wild chrysanthemum, and cordyceps.
Sixth, do not eat contaminated food, such as contaminated water, crops, poultry, eggs, etc., to eat some green organic food, to prevent disease from mouth.
Complication
Anka nephritis complications Complications, anemia, hypertension
Anemia, high blood pressure, respiratory infections.
Symptom
Anka symptoms of nephritis Common symptoms Kidney pain Urine foam dysuria Anuria oliguria edema
First, urine urine volume has varying degrees of change.
ANCA-associated vasculitis can cause a large number of small and medium-sized tubule cells to become necrotic or inflamed, and the amount of capillary blood tubules in the kidneys ranks among the top organs in the human body, which directly leads to rapid and serious damage to the kidney organs. The small tube is infiltrated by inflammatory cells, the glomerulus is severely damaged, and a large amount of protein and red blood cells are filtered into the urine, thereby forming proteinuria and hematuria. Blood is often detected due to vasculitis, and urine is forgotten, resulting in serious missed diagnosis. When the patient visually observed hematuria, kidney function has been severely impaired.
Because Anka nephritis is caused by vascular inflammation, there will be oliguria or polyuria. Patients often observe changes in their own urine volume and check them in time to avoid misdiagnosis.
Second, edema and high blood pressure are also one of the complications.
Due to insufficient kidney function, glomerular filtration decreases, causing water to transfer to the interstitial space, resulting in water metabolism, causing water and sodium retention, which is characterized by edema in vitro.
Patients with edema appear frequently with the appearance of high blood pressure. At this time, patients often have common symptoms of kidney disease such as low back pain, dizziness, blurred vision, and nocturia.
Examine
Anka nephritis check
Ultrasound of the kidney, kidney MRI, and renal function tests.
Diagnosis
Diagnosis and diagnosis of Anka nephritis
Differential diagnosis:
Diagnosis of acute nephritis
(1) Identification of acute nephritis and urinary tract infection.
Symptoms of atypical acute nephritis sometimes only have changes in urine, such as a small amount of protein, red blood cells, white blood cells without high blood pressure, edema, oliguria and other clinical signs and symptoms, and urinary tract infections have similar performance.
However, urinary tract infections generally have urinary tract irritation such as frequent urination, urgency, and dysuria. More routine white blood cells can be found in urine routine examination, and pathogenic bacteria can be found by urinary bacterial culture or smear microscopy. The use of antibiotic treatment has a good effect.
(2) Identification of acute nephritis and acute glomerulonephritis.
Chronic glomerulonephritis usually has a history of chronic nephritis such as edema and persistent hypertension, similar to the performance of acute nephritis. However, the urine density is generally not high, often fixed at about 1.010, and often occurs in red blood cell casts and granular casts. Kidney volume does not increase or even shrink.
Diagnosis of chronic nephritis
1. Identification of chronic nephritis and chronic pyelonephritis
The clinical manifestations of chronic pyelonephritis can be similar to chronic nephritis, but a detailed history of urinary tract infections (especially in women), more white blood cells in the urine, white blood cell cast, positive urine culture, intravenous pyelography and nuclear kidney map Check the performance of the two sides of the kidney damage. These are all conducive to the diagnosis of chronic pyelonephritis.
2. Identification of chronic nephritis and lupus nephritis
The clinical manifestations and renal histological changes of lupus nephritis are similar to those of chronic nephritis. However, systemic lupus erythematosus is more common in women and is a systemic disease that can be associated with multiple systemic manifestations such as fever, rash, and arthritis. Blood cells are reduced, immunoglobulins are increased, lupus cells can be found, antinuclear antibodies are positive, and serum complement levels are decreased. Renal histology showed that the immune complex was extensively deposited in various parts of the glomerulus. Immunofluorescence is often a "full hall" performance.
3. Identification of chronic nephritis and essential hypertension with renal damage
Chronic nephritis with increasing blood pressure should be differentiated from primary hypertension with renal damage. The latter age is usually 40 years old. Hypertension occurs before urine changes. Urinary protein is often not serious and tubular damage is obvious. Cardiac, cerebrovascular and retinal vascular sclerosis changes are often more pronounced. Some patients with chronic nephritis have refractory hypertension. The higher the blood pressure, the longer the duration, the more serious the condition and the poor prognosis. Malignant hypertension is more common in middle-aged people with hypertension, often causing renal insufficiency in a short period of time, so it is easy to be confused with chronic nephritis complicated by hypertension. The blood pressure of malignant hypertension is higher than that of chronic nephritis, often at 29/17kP (200/130mmHg) or higher. However, the initial changes in urine were not obvious, the amount of urine protein was small, there was no hypoproteinemia, and there was no obvious edema. Because small arteriosclerosis and necrosis in malignant hypertension is systemic, common retinal arterioles are highly constricted, with sclerosis accompanied by hemorrhage and oozing, papilledema, enlarged heart, and cardiac dysfunction. The basis for making a test.
