Chronic glomerulonephritis: classification, clinical presentation, treatment
Chronic glomerulonephritis is an immune-inflammatory disease that affects the glomeruli. Such a diagnosis is made if the disease lasts more than one year. As a rule, both kidneys are involved in the inflammatory process.
Causes of the disease
The main cause of the disease is not cured acute glomerulonephritis in time. The glomeruli become inflamed when exposed to streptococcus. The acute period of the disease can provoke hypothermia, injury in the lumbar region, alcohol abuse. With prolonged exposure to these factors, the disease turns into a chronic stage. Of course, such a process can occur without acute glomerulonephritis. If this happens, then such a nosological unit in nephrology is called primary chronic glomerulonephritis.The cause can be either an infection or the action of some chemical factors.
Chronic glomerulonephritis. Symptoms
The main symptoms are peripheral edema, hypertension, morphological changes in the kidneys, changes in the composition of urine. There are two stages in the course of the disease. The first is compensatory. It is characterized by minor renal dysfunction. That is, they are able to still produce end products of exchange. In the second stage (it is also called decompensation), the urinary function of the kidneys is significantly impaired. During this period, the main clinical picture appears: edema, hypertension, low urine density. If the treatment is performed on time or incorrectly, the decompensation stage can go to the uremic coma.
Chronic glomerulonephritis is divided into the following forms:
1. Nephrotic syndrome is characterized by a significant loss of protein in the urine (proteinuria). When this occurs, edema, a violation of fat and protein metabolism in the body. The patient is pale, notes pronounced general weakness, thirst, dry mouth, palpitations.In the urine there are leached erythrocytes (hematuria).
2. Hypertensive form begins gradually with an increase in blood pressure. This leads to an increase in the size of the heart, changes in the fundus.
3. Mixed form is difficult, difficult to treat. As a rule, it begins suddenly with the presence of large amounts of blood and protein in the urine.
4. The latent form is common. Occurs from 5 to 15 years. Changes in the urine are minimal.
5. The hematuric form is characterized by the presence of red blood cells in the urine.
Chronic glomerulonephritis. Treatment
Treatment begins with the appointment of a diet that limits the use of salt, protein and fluids. Preparations are selected for each patient individually. In case of detection of streptococcal infection, penicillin, fluoroquinolone or macrolide antibiotics are prescribed. It should be remembered that cephalonosporins are extremely nephrotoxic drugs, so it is better not to use them. Chronic glomerulonephritis, which occurs with edematous syndrome, involves the use of diuretics (drugs "Furosemide", "Lasix", "Trifast").
To combat hypertension, you should use ACE inhibitors (drugs "Enap", "Moeks", "Fozikard"). It is also advisable the appointment of immunosuppressants. Anticoagulants (Heparin and Clexan preparations) and antiplatelet agents are added to the treatment. It is recommended to conduct five sessions of plasmapheresis or hemosorption. Chronic glomerulonephritis is well treatable with the herbal preparations “Canephron”, “Urolesan”.