Nepritic syndrome is a dangerous inflammatory process that involves the glomeruli of the kidneys. This pathology is characterized by an increase in the level of nitrogen in the blood. It is worth noting that many confuse nephritic and nephrotic syndrome. These are two completely different kidney diseases, differing from each other in pathogenesis and clinical manifestations. In the first case, we are talking about inflammation of the organ, and in the second - about the damage to the kidney tissues. However, there is no fundamental difference between these two concepts. Nephritic syndrome and nephrotic syndrome are related diseases, manifested by different symptomatic complexes against the background of lesions of the excretory system.
Disease types
Nepritic syndrome is divided into three types according to the nature of the course:
- subacute - pathology develops onfor a long time, in some cases there are short-term symptoms;
- acute - this form manifests itself suddenly with severe pain in the lower back;
- chronic - in this form, relapses are replaced by remissions as a result of exposure to provoking factors.
What causes kidney nephritis
In most cases, the cause of the disease is a streptococcal infection. Acute nephritic syndrome does not manifest itself instantly, but with the active influence of the pathogen on the kidneys, the symptoms develop at lightning speed. It is worth noting another important nuance: this pathological condition never occurs in a person with he althy kidneys. For the occurrence of nephritis, a favorable condition is necessary - any kidney dysfunction.
Infection with streptococcus is far from the only factor that can provoke the development of the disease. In addition to the penetration of bacteria, autoimmune diseases, such as vasculitis, lupus, can become an impetus for the manifestation of the disease. In this case, nephritis appears against the background of the accumulation of glomerular complement in the basement membrane. A list with other potential causes of illness is as follows:
- poststreptococcal glomerulonephritis (nephritic syndrome develops against the background of bacterial damage to the deep tissues of the organ);
- meningococcus;
- pneumococcus;
- typhoid;
- endocarditis;
- sepsis;
- viral infections (chickenpox, hepatitis, mumps, rubella, measles, infectious mononucleosis, syphilis, etc.);
- autoimmuneviolations.
Possible simultaneous impact of several of these factors. However, any form of nephritic syndrome can lead to complications and adverse consequences.
By what signs to recognize
Diagnosis of nephritic syndrome, as a rule, is not difficult for specialists. The disease is characterized by a number of specific symptoms that can be confused with other renal pathologies with a low degree of probability. Meanwhile, special attention is paid to the differential diagnosis of nephritic syndrome from nephrotic.
The patient may feel the first symptoms of nephritis some time after the infection enters the body. The duration of the incubation period depends on the type of pathogen. For example, streptococcus manifests itself 10-15 days after infection.
All signs of jade are divided into classical and general. The first group includes manifestations that occur in every patient with nephritic syndrome:
- Presence of a significant amount of blood in the urine (hematuria). In a severe form of the disease, gross hematuria is possible (urine is colored maroon in color, acquires a thicker consistency), but this symptom occurs only in a third of patients.
- Hypocomlementimia - focal and segmental necrosis with proliferation of epithelial cells of the renal glomeruli.
- Swelling of the face and lower extremities. The face and neck begin to swell in the first half of the day, and the legs in the second; afterawakening in patients observed cardiac swelling of the lower abdomen and ankle joints.
- Development of arterial hypertension.
- Acute insufficiency of the left ventricle and auricle, expressed by increased heart rate and pulmonary edema.
- Decreased urine output.
Non-specific symptoms
They are characteristic of many diseases. Most often, these symptoms appear first. These include:
- prolonged lack of appetite and consequent weight loss;
- persistent headaches;
- fluid retention in the body and swelling of the body;
- persistent fever, 37-38°;
- sharp pain on palpation and light pressure on the lumbar region and abdomen;
- weakness, malaise;
- nausea, vomiting.
The most severe consequence of nephritic syndrome in children is its smooth transition into a chronic form. The constant nature of the course of the disease can be very dangerous. Chronic nephritic syndrome is latent, and therefore it is possible to recognize relapses and start timely treatment only in isolated cases.
Is there a difference between nephritis and nephrosis
As already noted, nephritic and nephrotic syndromes are different sets of clinical signs that manifest themselves in the development of renal pathology. These two conditions have similar features and occur against the background of existing disorders or infectious lesions. Since both pathological processes have a common localization, the symptoms are practicallyare the same for nephritic and nephrotic syndrome. The differences will be in the results of the tests and other signs of damage to the excretory system. As for the general symptoms, the course of nephrotic syndrome is accompanied by swelling, general weakness, back pain and pallor of the integument.
Main differences
Nephrotic and nephritic syndromes are essentially consequences of other kidney diseases. Both pathological conditions have a number of common features, however, due to the difference in the course, specialists manage to differentiate them from each other, make the correct diagnosis and prescribe the correct treatment.
The difference in laboratory results is the main difference between nephritic and nephrotic syndrome. You can visually familiarize yourself with the features of each of the pathologies in the table below.
|
Differential criteria |
Nepritic syndrome | Nephrotic Syndrome |
| What provokes | Jade | Nephrosis |
| Current pattern | Arises unexpectedly, develops at lightning speed | Mostly sluggish, protracted course |
| Laboratory blood tests | High eosinophils, low hemoglobin | Increased presence in the bloodplatelets and leukocytes |
| Laboratory urine tests | Hematuria confirmed (blood in urine) | Urine protein over 10 times normal, high lipid levels |
| Ultrasound data | Kidney enlargement, heterogeneous parenchyma structure | Sclerotic foci are detected |
Diagnosis
To confirm the diagnosis, the patient is prescribed urine and blood tests, the results of which determine the indicators of oliguria, proteinuria, the number of erythrocytes and leukocytes, changes in AT titer, and a decrease in the hemolytic activity of some complements.
Without fail, the patient is sent for ultrasound screening and X-ray examination - instrumental diagnostics will provide accurate data on the size of the kidneys and the rate of filtration processes in the glomeruli.
Basic principles and approaches to treatment
Clinical recommendations for nephritic syndrome come down to one thing - the fight against the root cause. The attending physician draws up a strict diet for the patient, which implies a ban on s alt and a limited intake of protein foods. The daily volume of fluid is also subject to reduction. Without fail, spices, acidic drinks, black tea, coffee, fried and canned foods are excluded from the diet.
Very important in the treatment of nephriticsyndrome to ensure sufficient intake of vitamins and valuable trace elements in the body. Semi-finished products and fast food should be abandoned. With nephritic syndrome, carrots and lettuce containing vitamin A, nuts, beets and apples, in which vitamin B is present, should be included in the diet. Ascorbic acid, which is rich in citrus fruits, cabbage, bell peppers and rose hips, will help strengthen the immune system. Vitamin E is found in beans and vegetable oils.
Unlike nephritic syndrome, nephrotic syndrome is manifested by a more pronounced retention of fluid and s alts in the body. However, specialists prescribe drugs to restore water-s alt metabolism and diuretics in both cases. If nephritis or nephrosis passes into an acute stage, complicated by the development of renal failure, the patient is shown dialysis and appropriate resuscitation measures. Treatment is carried out under the constant supervision of medical staff.
Drug therapy
For the symptomatic treatment of nephritic syndrome, the patient is prescribed drugs of the following groups:
- Diuretics.
- Calcium-containing products.
- Antiallergic.
- Vitamin-mineral complex (ascorbic acid, rutin).
- Antibiotics (in the presence of an infectious focus in the body).
- Antihypertensive and cardiac drugs.
For nephritic syndrome, diuretics are used, such as:
- Thiazides. "Hypothiazide" (analogous to "Dichlothiazide") is prescribed in a dosage1 to 4 tablets daily.
- Furosemide and ethacrynic acid. The drug "Lasix" for the treatment of symptoms of nephritic syndrome is taken orally or by injection at a dose of not more than 200 mg per day. Orally, the drug is taken on an empty stomach, the entire dose is administered simultaneously and with intravenous infusion. "Uregit" (the main active ingredient is ethacrynic acid). The principle of action is similar to the previous drug, which is based on the active substance furosemide. "Uregit" is prescribed after a meal, starting with 50 mg per day (1 tablet). Gradually increase the dosage to a maximum of 200 mg.
- Potassium-sparing diuretics. This group includes the drugs "Aldactone" and "Veroshpiron" - effective aldosterone antagonists. Such drugs are also prescribed for the treatment of nephritic syndrome, not accompanied by hyperkalemia.
With arterial hypertension, Anaprilin is prescribed for the treatment. However, this drug is not suitable for bradycardia. Usually prescribed means of 60-160 mg / day. For patients with heart failure with nephritic syndrome, glycosides are required. Before prescribing to the patient the intake of drugs of this group, the level of potassium in the blood plasma is necessarily determined, since such drugs are contraindicated with low rates (less than 3.5 mmol / l). During periods of remission of the disease, staying in a resort area with a dry climate will be beneficial.
Possible Complications
With the unclear pathogenesis of nephritic syndrome, it is not easy to overcome the disease. Due to the long course of the disease, kidney cells begin to die. The organ decreases in size and gradually loses its functionality. If the kidney function cannot be restored, the patient is transferred to hemodialysis. The decision to artificially maintain the functioning of the excretory system means only one thing - the patient needs urgent organ transplantation. A kidney transplant is an expensive surgical procedure that also requires a long rehabilitation period.
In parallel with the pathological process in the kidneys, the work of the cardiovascular system is disrupted, as a result of poor-quality blood purification. Arteries become thinner, slow necrotic changes are observed in myocardial cells. At the same time, death in nephritic syndrome is an extremely rare phenomenon. Most often, death occurs in elderly patients suffering from heart failure.
Forecast
Due to the timely differential diagnosis of nephrotic syndrome, patients are more likely to have a speedy recovery without complications. In general, the prognosis for patients is favorable. It is important to seek help from specialists at the first symptoms of the disease - competent therapy will help normalize kidney function in a couple of months. The course of the disease largely depends on the stage of the disease, the age of the patient and the presence of chronic diseases that can aggravate the clinical picture.
In most cases, the elimination of the inflammatory process automatically entailsis a stabilization of blood pressure, but this only happens if the cause of hypertension was precisely kidney problems, and not some other disease, accompanied by the same symptom.
In the course of nephritic syndrome, associated with serious complications (uremic coma, acute heart failure, cerebrovascular accident, etc.), the prognosis is unfavorable. Among the most common consequences, it is worth noting a severe form of anemia and recurrent hypertensive crises.
Folk treatment
Kidney diseases have long been treated with herbs. Despite modern technologies and advances in the medical industry, many people still suffer from diseases of the excretory system today. At the same time, traditional treatment is not always effective and safe enough - many drugs have a wide range of contraindications and side effects.
Properly selected remedies, which are prepared at home according to the recipes of traditional healers, really help to alleviate the patient's condition. For folk treatment, various decoctions and infusions of herbs are used. Specialists often prescribe alternative methods to patients at the same time as medications for nephritic syndrome. According to the recommendations of doctors, the most effective are the products prepared according to the following recipes:
- Rosehip infusion. The drink is prepared as follows: two tablespoons of dried fruits are poured into 500 ml of boiling water. Then the product is left for 1 hour to infuse. Strained and cooled drink is acceptedduring the day, every two hours, a few sips.
- Infusion of birch leaves. Raw materials are poured with hot water in a ratio of 1:2. It will take several hours to infuse the leaves, so it is best to prepare the infusion in the evening and leave until the morning, covered with a lid. The remedy is taken half a glass three times a day after meals.
- Infusion of calendula flowers, knotweed, bark, water lily, St. John's wort, chamomile, chicory flowers, immortelle. All components are used in equal quantities (1 tablespoon each), mixed and poured into 1 liter of hot boiled water. The infusion is drunk before breakfast and dinner, 100 ml each.
- Infusion of horsetail and bear ears. Dry birch leaves are sometimes added to herbs. Prepare the remedy in the same way as the previous one. It takes at least half an hour to infuse the drink. You will have to drink the medicine daily for half a glass on an empty stomach.
Prevention
Often, the attending physician with a mild degree of nephritic syndrome recommends the use of folk remedies for prevention. However, in this case, decoctions and infusions are prepared in a lower concentration of active ingredients. The use of medicinal herbal drinks implies compliance with the dosage corresponding to the age, weight and other individual characteristics of the patient. In addition, the likelihood of developing an allergic reaction and intolerance to certain substances cannot be discounted.
In general, the prevention of nephritic syndrome is to prevent underlying pathologies. AtViral and bacterial infections can lead to heart failure, which negatively affects kidney function.
It is important to strictly follow all prescriptions and recommendations of doctors. It is impossible to interrupt the treatment of kidney disease. Even those patients who have achieved full recovery have to take drugs for a long time and follow a special regimen.
Remember that the kidneys are a kind of filter that helps our body get rid of toxins and harmful substances. Treat your he alth with care and do not self-medicate!
