Acute and chronic glomerulonephritis: symptoms, diagnosis, treatment
Diagnosis, treatment of glomerulonephritis and its prevention is a complex process. Glomerulonephritis is a whole complex of diseases characterized by massive damage to important structures - kidney glomeruli. Basically, the process starts after a streptococcal infection - even after a banal sore throat. In most cases, the disease proceeds in the form of acute glomerulonephritis, the treatment of which largely depends on the adequacy of the treatment of the previous angina.
Structure of the kidney and types of glomerulonephritis
The kidney consists of small lobes - a large number of glomeruli. In these small structures, fluid is filtered from the blood into the kidneys, and this is how human urine is formed. During the development of glomerulonephritis, the correct step-by-step process of filtration breaks down, because the permeability of the capillaries that permeate the kidney tissue is disturbed. The walls of small and large capillaries are damaged, blood elements (erythrocytes, as well as protein fractions) pass unhindered into the urine. On the other hand, a diseased kidney is not able, as before, to remove excess water and toxic products from the body.
Among kidney diseases, glomerulonephritis, its symptoms and treatment are the most frequently discussed topic in nephrology by clinicians.
According to the classification, primary glomerulonephritis, which develops in previously unaffected kidneys, and secondary glomerulonephritis, a consequence of other diseases, are distinguished. The duration of the acute process is from 1 to 4 weeks, the subacute process is a couple of months, and the chronic process is a year. Chronic glomerulonephritis is one of the most frequent reasons for the development of chronic kidney failure. Because of its development, patients may need hemodialysis in complex and advanced cases, and in critical situations, kidney transplantation.
The hematuric form of glomerulonephritis is manifested by a huge amount of various blood elements in the urine. When the vessels of the glomeruli are massively affected, the process spreads throughout the kidney.
Causes of the disease
Groups of factors can act as an impetus for the development of glomerulonephritis:
- Microbial agents (more often streptococcal, less often viral, even less often parasitic). Infectious agents do not directly affect the glomeruli of the kidneys - the process has a complex immune nature. This is the explanation why glomerulonephritis does not occur immediately, but several weeks after the onset of nosology.
- Poisonous substances (household solvents and dyes, low-quality alcohol, narcotics, some types of drugs) - as a result, hematuric glomerulonephritis occurs.
- Systemic pathologies (primarily nodular periarteritis, various types of vasculitis, systemic amyoidosis).
- Congenital pathologies, when the kidneys are primarily affected (Fabry disease).
Symptoms of glomerulonephritis
Glomerulonephritis has symptoms not only from the side of the kidneys. The first bells are a sharp increase in blood pressure, swelling (indicative of acute glomerulonephritis with nephrotic syndrome in children), a decrease in urine volume. It is important to be vigilant when the listed symptoms appear after a fresh strep throat. After all, acute glomerulonephritis starts after it, the diagnosis of which is facilitated by the presence of angina in the recent history.
Instrumental and laboratory methods of diagnosis help to confirm the diagnosis. Among the latter, the general analysis of urine is the most informative. In glomerulonephritis, this analysis helps to identify protein (proteinuria), erythrocytes (hematuria, typical for the hematuric form of chronic glomerulonephritis) and atypical elements (cylinduria) in the urine. An effective auxiliary method is a biochemical blood test. With its help, in case of glomerulonephritis, an imbalance of various protein fractions in the blood (the so-called dysproteinemia), sometimes – an increase in the amount of fat fractions (hyperlipidemia) and non-protein nitrogen (hyperazotemia) is ascertained.
Diagnosis of the disease, types of examination
Often, there are few manifestations of glomerulonephritis for diagnosis. In addition to extensive biochemical analyzes of urine and blood, in order to confirm the diagnosis, measurements of glomerular filtration rate and creatinine level are used, and an analysis is made for the presence of antistreptococcal antibodies in the blood (an indirect method of confirming the disease). Instrumental methods that are most often used in clinics to confirm the diagnosis are radionuclide renography, renoscintigraphy, ultrasound, as well as computer tomography of the retroperitoneal space (where the kidneys are located). Simple examination methods available to everyone will help to facilitate the diagnosis, for example, regular blood pressure measurement - it can be increased in the hypertensive form of chronic glomerulonephritis. To verify the diagnosis of glomerulonephritis, it is necessary to perform a kidney biopsy (an invasive method where a small fragment of tissue is taken with a surgical instrument and examined under a microscope).
Latent glomerulonephritis can be hidden, asymptomatic or with a minimal set of signs.
Treatment of glomerulonephritis
Treatment in most cases is difficult and requires hospitalization. Long-term strict bed rest is prescribed, as well as diet No. 7 (it is traditionally prescribed for kidney pathologies, based on the exclusion of fatty, salty, spicy, fried food).
Among medicines, antibiotics of different generations and immunosuppressants are successfully used. Quite often, the affected kidney cannot cope with its duties, and hemodialysis cannot be dispensed with. Chronic glomerulonephritis proceeds more slowly, its treatment does not require shock doses of antibiotics.
The pathological process in the smallest patients can proceed sluggishly, sometimes atypically. How to treat glomerulonephritis in children can only be voiced by a pediatric nephrologist.
Prophylaxis of glomerulonephritis in adults, children and pregnant women
This disease is easier to prevent than to treat. If any streptococcal diseases (skin infection, angina) occur, it is extremely important to cure them quickly and efficiently, so that the infection does not have time to spread to the kidney structures. Unfavorable glomerulonephritis in pregnant women is emphasized, because it can provoke premature birth.
Useful information about the symptoms, treatment and prevention of this disease is presented on our website: Dobrobut.com.
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