Jade (synonym: glomerulonephritis, glomeruli) - bilateral diffuse inflammation of the kidneys most defeat of vessels of the glomeruli.
The clinical course there are acute and chronic nephrite.
Acute nephritis. The origin of acute nephritis is essential streptococcal infection (sore throat, scarlet fever). The disease is not infectious-inflammatory (because you cannot detect microbial pathogen or urine, either in the blood or tissues of the kidneys), and allergic post-infectious (see Allergy). This is evidenced by the fact that the disease develops in 2-3 weeks after infection.
Great importance in the development of acute nephritis develop in the body of autoimmunity; consider that an infectious agent that damage the kidney, promotes formation of antibodies to its own tissues of the kidney. Cooling contributes to the development of jade, causing reflex circulatory disorders and nutrition kidney and changing of protective and adaptive properties of the organism.
Acute nephritis occurs more frequently in young adults, begins acutely and is characterized by swelling, hypertension and pathological changes of urine. In patients with a headache, shortness of breath, sometimes resulting in asthma (cardiac asthma), a sharp decrease in urination, sometimes complete anuria (see) and the rapid development of edema. Swelling are located primarily on the face and in combination with pale skin produce characteristic appearance of the patient. In subsequent swelling spread throughout the body, and sometimes the fluid in the cavities of the pleura, pericardium, abdominal cavity.
Hypertension often preceded by other symptoms of the disease is usually mild and transient in nature; and a significant increase in blood pressure (200/120 mm RT. Art.). Hypertension when jade is the cause of development marked circulatory insufficiency (dyspnea, hemoptysis, asthma cardiac asthma). When patients are determined by the enlargement of the heart, the focus of the second tone of the aorta, systolic murmur at the top, bradycardia, congestive wheezing in his lungs.
With high numbers of blood pressure, swelling of the brain may develop nephritic eclampsia. Eclampsia is manifested redchajshie headaches, vomiting, convulsive seizures with tongue biting, dilated pupils, darkening of awareness, involuntary discharge of urine and feces.
In acute nephrite observed hematuria (see) and proteinuria (see). Microhematuria is observed from the first day of the disease, sometimes turning into a makrogematuriya (urine color "meat slops"). In urine sediment are leached erythrocytes to 100-200 in the field of view, and leukocytes, cylinders and renal epithelium. The amount of protein in the urine is usually no more than 1-3%. Kidney function in acute nephritis little disturbed.
The diagnosis of acute nephritis not difficult if there is swelling, hematuria, proteinuria, hypertension, is characterized by the rapid development of the disease after cooling or recent infection. In the absence of typical signs of the disease the diagnosis can be made at regular measurement of blood pressure and urine. When expressed one of the characteristic symptoms of the disease, should differential diagnosis with chronic nephritis, hypertensive disease (see), nephritic syndrome (see).
Prognosis in acute nephritis favorable, most of the symptoms disappear when treatment after 1-2 months. and begins recovery. In exceptional cases, there are deaths from hemorrhage in the brain or from acute heart insufficiency. The possible transition of acute nephritis in chronic in cases where the symptoms do not disappear within a year.
Treatment: the main condition of treatment is strict rest content.
In acute nephritis with swelling, change in urine and hypertension are shown in the first 1-3 days "mode of hunger and thirst", i.e. excluding food and fluid restriction to 300 ml (Morse, Borjomi). Following the "hungry" days appoint 1-2 "sugar" day (drinking 1-1,5 l, 10% solution of sugar per day). Further add different carbohydrates and vegetable protein, salt limited to 1-2 g per day. After 1 - 2 weeks diet expand by adding milk, sour cream, potatoes. Daily diet - protein-40 g, fat 70 g, carbohydrates 450 g, salt of 3 g In the following diet is expanding at the expense of proteins, fats and carbohydrates, allowed the addition of 5 g of salt, remains salt-free cooking. When full recovery is the return to a normal diet. Alcoholic beverages are excluded for a long time.
Of drug therapy is recommended for intravenous infusion 20-40 ml of 40% glucose solution with 1-2 ml of 5% solution of ascorbic acid. To lower blood pressure and increase diureza - reserpine in the 0.1-0.25 mg three times a day. When asthma - intravenous 0.5-1 ml of 0.05% solution strofantina with 10 ml of 40% glucose solution (slowly!), subcutaneous caffeine, camphor oil and promedol on 1 ml.
In eclampsia - intramuscularly 20-25 ml of 25% solution] magnesium sulfate 1-2 times a day, intravenous papaverine 1 ml 2% solution (enter slowly!), in mikroklizm chloral hydrate 1.5-2.0 g, subcutaneous morphine 1.0 ml of 1% solution. Treatment of acute nephritis in the hospital carried out until the swelling, hypertension, macrohematuria and severe proteinuria.
Patients undergoing acute nephritis, should be under medical supervision (required periodic measurements of blood pressure and urine).
Prevention of acute nephritis is the prevention and treatment of acute infectious diseases and rehabilitation foci of infection in the mouth cavity and nasopharynx. Prohibited work involving physical strain and cooling.

  • Nephritis in children