Chronic nephritis

Chronic nephritis develops after acute nephritis with progressive disease course. May develop chronic nephritis without prior acute onset as a result of latent flowing, oligosymptomatic acute nephritis.
Etiological factors of chronic and acute nephritis similar. A significant role in the development of chronic nephritis belongs to the reactivity of the organism and autoimmune disorders. The damaged cells of the affected organs patients become foreign antigen, causing the formation of autoantibodies that supports chronic nephrite. Unfavourable conditions of work and life, and the presence of focal infections (chronic tonsillitis, otitis, adnexitis , and others) contribute to the transition of acute nephritis chronic.
For chronic nephritis is typical primary defeat of the glomeruli. Anatomical changes in the kidneys depend on the form of chronic nephritis. Along with wrinkled glomeruli can detect the glomeruli with signs of acute nephritis, and in the epithelium tubules-dystrophic changes.
Chronic nephritis, as a sharp, manifested edema, hypertension and changes in the urine. There are four main forms of chronic nephrite.
1. Subacute malignant jade characterized resistant hypertension, persistent edema, increased cholesterol blood, decrease beats. weight of the urine and a violation of the kidney nitrogen-excretion function with outcomes in uremia (see), leading to death.
2. Chronic nephritis nephrotic type is characterized by pronounced edema, significant proteinuria and cylindruria of all kinds. In blood there is a decrease in the number of total protein (up to 4 - 5 g %), increase blood cholesterol (600 mg% and above). Kidney function remains a long-term (up to 2-6 years)and then developing renal insufficiency; death from uraemia.
3. Chronic nephritis mixed type characterized by persistent edema, high blood pressure and in a few years the development of chronic uremia.
4. Chronic nephritis hypertension type is characterized by changes in the cardiovascular system: a significant increase in blood pressure, recurrent nosebleeds, vascular spasm, vision impairment may develop cardiac asthma. Changes in urine is a minor - moderate microhematuria, and proteinuria. In the next picture develops chronic uremia.
The diagnosis of chronic nephritis simple in the presence of acute nephritis in history and the characteristic symptoms of the disease. When expressed only individual symptoms or no connectivity with acute nephritis, you differential diagnosis with other lesions of the kidneys.
Unlike hypertension, hypertonic type of chronic nephritis - urine changes precede arterial hypertension, cardiac hypertrophy less pronounced, less likely to cause a hypertensive crises and less intensively developing atherosclerosis. When differentiation with chronic pyelonephritis is set to prevail in urine sediment erythrocytes over leukocytes in chronic nephritis.
Nephrotic (swollen-albuminuria) form of chronic nephritis should be differentiated with nephrotic syndrome (see). Chronic nephritis, along with nephrotic syndrome always there are signs of inflammation of the kidneys in the form of moderate hematuria, reduce kidney function and the tendency to increase in blood pressure. Outcome of chronic nephritis is secondary puckering kidneys with the development of chronic renal failure and uremia.
Pregnant women should be differentiated jade and nephropathy. It should be taken into consideration that nephropathy pregnant (see) is observed in the second half of pregnancy. In severe nephritis in pregnant women may be premature birth, intrauterine death of the fetus, white heart attacks in the placenta and her premature detachment. The cases are very heavy flow of jade in pregnant women are an indication for abortion.
The basis for the prevention of chronic nephritis is timely and correct treatment of acute nephritis and elimination of focal infection. If a satisfactory General condition, the absence of high numbers of blood pressure and expressed events of deficiency of kidney patients shown sanatorium treatment in the warm seasons resorts Turkmenistan, Kyrgyzstan, Uzbekistan and southern coast of the Crimea.
Treatment. Diet for chronic nephritis should be rich in vitamins, restriction of salt and fluid swelling and hypertension. With nephrotic type of chronic nephritis with saved Attigliano renal function (ID weight of the urine is not lower than 1020) diet should contain large amounts of protein (150-200 g per day). Of medicine shows the use of corticosteroids (under medical supervision) or of Raskina to 0.25 g twice a day, and then once a day for several months. At hypostases - gipotiazid on the 25-50 mg per day with simultaneous taking in of 2-4 g / day of potassium chloride.
Treatment of hypertensive type of chronic nephritis is conducted as in hypertensive disease (see). Treatment uremia - see Uremia.