chronic nephritis
Introduction
Introduction to chronic nephritis Chronic glomerulonephritis, referred to as chronic nephritis, refers to proteinuria, hematuria, hypertension, edema as the basic clinical manifestations, the onset of the disease is different, the disease is prolonged, the lesion progresses slowly, may have varying degrees of renal dysfunction, with kidney A tendency to worsen the function and eventually develop into a group of glomerular diseases of chronic renal failure. Due to the pathological type and duration of the disease, the main clinical manifestations may vary. The disease manifests itself in diversity. Chronic nephritis is a group of glomerular diseases with multiple causes of chronic glomerular lesions, but the cause of most patients is unknown. Those with obvious hypertension, edema or short-term renal dysfunction should stay in bed and limit the intake of salt to 2 ~ 3g. For those who have lost more protein in the urine and have good renal function, it is advisable to supplement the animal protein with high bioavailability, such as eggs and milk, and those with renal dysfunction (endogenous creatinine clearance rate is about 30ml/min). Limit the protein to about 30g, if necessary, add an appropriate amount of essential amino acids. basic knowledge Sickness ratio: 0.05% Susceptible people: mainly young and middle-aged men Mode of infection: non-infectious Complications: Hypertension Chronic renal anemia
Cause
Causes of chronic nephritis
Cause
Chronic nephritis is a group of glomerular diseases with chronic glomerular lesions with multiple causes, but the etiology of most patients is unknown, and there is no clear relationship with streptococcal infection. According to statistics, only 15% to 20% from acute glomerulonephritis The change is due, but because the subclinical type of acute glomerulonephritis is not easy to be diagnosed, the percentage may be higher. In addition, most patients with chronic nephritis have no history of acute nephritis, so many scholars believe that chronic glomerulonephritis There is no positive correlation with acute nephritis. It may be caused by infections such as various bacteria, viruses or protozoa through immune mechanisms, inflammatory mediators and non-immune mechanisms.
Prevention
Chronic nephritis prevention
The most fundamental way to prevent chronic nephritis is to improve the body's ability to prevent disease and disease, reduce the chance of infection, and prevent the cause.
1. Avoid overwork and stress: overwork, night drive, high pressure on exams, etc., can make chronic nephritis worse, have good living habits, maintain a regular life, and usually arrange a life and rest system. Participate in appropriate activities and strengthen physical exercise, but should avoid overwork, reasonable nutrition, enhance physical fitness and body resistance, pay attention to personal hygiene and environmental sanitation, develop good hygiene habits, and keep your mood relaxed and happy at any time. Strengthen self-care awareness.
2, beware of bacterial or viral infections: bacterial or viral infections are the most common causes of acute nephritis, especially upper respiratory tract infections, asymptomatic bacteriuria, flu, pharyngitis, tracheobronchitis, etc., may cause chronic symptoms of kidney inflammation .
Actively prevent and treat infected lesions, actively prevent acute nephritis, reduce the chance of infection, prevent cold and cold, prevent cold, suppurative tonsillitis, skin suppurative infection and other diseases; once infected with the above diseases or acute nephritis and other primary diseases For glomerular disease, timely and thorough treatment should be given. Patients with acute nephritis have chronic infections. After the condition is stable for 3-6 months, if necessary, surgery can be used to cure the disease. Nephritis.
3, pay attention to diet nutrition: patients with nephritis should avoid high-protein diet, pay attention to food safety, eat more fresh fruits and natural foods, with a variety of varieties, with reasonable, light and delicious principle.
Pay attention to self-monitoring, if you feel unwell, if there is more nocturia, loss of appetite, waist discomfort or soreness, especially after getting up in the morning, facial edema and abnormal urination, suggesting that you may have kidney disease. It is necessary to go to the hospital for examination in time to facilitate early diagnosis and treatment, and it is also important to prevent this disease.
Complication
Chronic nephritis complications Complications, hypertension, chronic renal anemia
Chronic nephritis patients with low resistance, prone to easy respiratory, urinary tract and skin infections, there may be no obvious symptoms after infection, treatment is more difficult, should be noted.
Symptom
Chronic nephritis symptoms common symptoms proteinuria edema hematuria high blood pressure reticular leukoplakia and gangrene body weight loss type urinary amylase increased urinary filtration score decreased significantly decreased urine osmotic pressure
Chronic glomerulonephritis can occur at any age, but is predominantly young or middle-aged. The onset and clinical manifestations are diverse. Most of the onsets are insidious, slow, with hematuria, proteinuria, hypertension, edema as their basic clinical manifestations, may have varying degrees of renal dysfunction, disease prolonged, repeated, progressive development of chronic renal failure. Normal or mildly impaired renal function (decreased creatinine clearance or mild azotemia), which can persist for years, even decades, with progressive deterioration of renal function and corresponding clinical manifestations (eg anemia, blood pressure) Increase, etc.), into uremia.
Examine
Chronic nephritis check
First, urine routine: urine specific gravity is low, mostly below 1.020, the disease is often fixed at 1.010 in the late stage, urine protein is ~~++, and there are often red blood cells and casts in the urine (granular tube type, transparent tube type), acute There is obvious hematuria or gross hematuria during the attack.
Second, blood test: often light, moderate positive pigmented anemia, red blood cells and hemoglobin proportion decreased, ESR increased, may have hypoproteinemia, general serum electrolytes no obvious abnormalities.
Third, renal function test: glomerular filtration rate, endogenous creatinine clearance rate decreased, blood urea nitrogen and creatinine increased, renal function staging mostly compensated or decompensated period, phenol red excretion test and urine concentration dilution The function is reduced.
Diagnosis
Diagnosis and diagnosis of chronic nephritis
diagnosis
Typical case diagnosis is not difficult, with proteinuria, hematuria (multiple morphological changes in red blood cells), hypertension, edema, renal insufficiency and other clinical manifestations of glomerulonephritis, duration of more than 1 year, except for secondary Patients with glomerulonephritis should consider this disease.
Differential diagnosis
In the differential diagnosis, it needs to be differentiated from chronic pyelonephritis, chronic renal interstitial nephritis, lupus nephritis, purpuric nephritis and hereditary nephritis.
