Glomerulonephritis is an inflammatory disease that affects the small vessels of the kidneys called glomeruli. According to the etiology, manifestations, course of the disease and its outcome, several forms are distinguished.
What are they characterized by? What generally provokes the occurrence of this disease? What is the pathogenesis of glomerulonephritis? What symptoms indicate its presence? And how to deal with this disease? This is worth talking about in more detail.
Classification
First of all, you need to refer to the ICD-10. Glomerulonephritis, in accordance with the international classification of diseases, belongs to the heading N03. This code stands for chronic nephritic syndrome.
According to this document, ICD-10 glomerulonephritis is as follows:
- Diffuse membranous: N03.2.
- Mesangial proliferative: N03.3.
- Endocapillary proliferative: N03.4.
- Mesangiocapillary: N0З.5.
- Diffuse crescent: N0З.7.
The form of the disease a person has been exposed to is only revealed in the process of conducting a detailed diagnosis. Because the external manifestations of the disease are nonspecific. Symptoms will be similar in both diffuse membranous and crescentic glomerulonephritis.
Mechanism of disease progression
Now we should discuss the pathogenesis of glomerulonephritis. The development of this disease in all cases is associated with an acute or chronic infection, which is localized in different organs and usually has a streptococcal origin.
Rarely, glomerulonephritis is caused by chemical poisoning, vaccination, or the abuse of foods containing preservatives.
The development of this disease begins with the formation of immune complexes in the kidneys or blood - antibodies that are associated with the surface antigens of a bacterial cell. Their level increases, and the number of complex proteins (C3-complements) decreases.
If a biopsy is performed at an early stage of glomerulonephritis, then glomerular damage from 80 to 100% will be found in the test material. It is also possible to notice clumpy granular deposits along the basement membranes of the glomerular capillaries, consisting of the notorious C3-complement and immunoglobulin G.
Course of disease
There are two main options:
- Cyclic(typical). It is manifested by a rapid onset and a significant severity of clinical symptoms.
- Acyclic (latent). This is an erased form of the disease, which is characterized by a gradual onset and mild symptoms. It is more dangerous, unlike the previous one, as it is usually diagnosed late, and eventually leads to the fact that the disease becomes chronic.
This is about acute glomerulonephritis. But, as mentioned earlier, very often it becomes chronic. And in this case, the following variants of the course of the disease are possible:
- Hypertonic. With this form of flow, urinary symptoms are very mild. Basically, the patient suffers from constantly high blood pressure.
- Nephrotic. Glomerulonephritis in this case is accompanied by the manifestation of pronounced urinary symptoms.
- Mixed. It is characterized by a combination of both of the above syndromes.
- Latent. A common form of the course of a chronic form of the disease. It is characterized by the absence of arterial hypertension and edema. The nephrotic syndrome is very mild.
- Hematuric. A difficult case, since the only symptom is the presence of erythrocytes in the urine, and this can only be detected by submitting this biomaterial for analysis.
Talking about the forms of the course and the pathogenesis of glomerulonephritis, it should be noted that any variant is characterized by a relapsing course. When an exacerbation occurs, then all clinical symptoms completely repeat the first episode.disease, or at least resemble it.
The likelihood of relapse, by the way, increases in spring and autumn. It was during this period that cases of infection with streptococcal infection are especially frequent. And if a person has already suffered one of the forms of glomerulonephritis once, then a relapse will occur 1-2 days after exposure to an irritant.
Symptoms
Since we are talking about the causes and pathogenesis of glomerulonephritis, it is necessary to list the signs by which the presence of this disease can be recognized.
The first symptoms appear 1-3 weeks after a streptococcal infection. Most often it is tonsillitis, pyoderma and tonsillitis.
So, the presence of this disease is usually indicated by the following symptoms:
- Changing the color of urine. Its quantity increases, but the density decreases.
- Fever.
- Pain in the lumbar region.
- Slight chills that get worse over time.
- General weakness.
- Lack of appetite.
- Nausea.
- Headache.
- Puffiness and pallor.
It should also be noted that urine with glomerulonephritis becomes pink or red over time. This is due to hematuria - the presence of blood in it.
This symptom can also have a different severity. Approximately 85% of patients develop microhematuria - in this case, the presence of red blood cells in the urine can only be detected by examining the biomaterial under a microscope. But 15% of patients have gross hematuria. In such cases, urinemay turn black or dark brown.
Hypertension (increased blood pressure) is also a common symptom. With a severe form of the disease, it lasts for several weeks.
And it should also be noted that glomerulonephritis, the causes and symptoms of which are now being discussed, often causes damage to the cardiovascular system, as well as problems with the central nervous system and liver enlargement.
Complications
If a person does not pay attention to the symptoms in time and does not go to the doctor, then he will have to face the consequences. As a rule, the following complications of glomerulonephritis develop:
- Pulmonary edema. It is highly likely to occur in people suffering from heart disease and hypertension.
- Eclampsia. It is characterized by a sharp increase in pressure, epileptic seizures, convulsions and a hypertensive crisis.
- Toxification of the whole body (uremia).
- Acute heart failure. Occurs in 1% of cases.
- Acute renal failure. Occurs in 3% of cases.
- Intracerebral bleeding.
- Hypertensive encephalopathy.
- Impaired vision.
- Diffuse chronic glomerulonephritis.
To avoid the consequences, you need to be responsible for your he alth. In the early stages, glomerulonephritis is curable completely. You can get rid of it in a few weeks, and still avoid complications.
Diagnosis
First of all, the doctor interviews the patient. It is important to find out what kind of disease he recently suffered, because glomerulonephritis has an infectious nature of occurrence.
Then a visual inspection is carried out, and only then the person is sent for analysis. As a result of the study, it is possible to identify the following changes:
- Content of erythrocytes in urine. At the initial stage they are fresh. On later ones - leach.
- Albuminuria (moderate, 3-6%).
- Hyaline or granular casts in urinary sediment.
- Deterioration of the filtration function of the kidneys. Determined by studying endogenous creatinine clearance.
- Reduced diuresis and nocturia. Detected through the Zimnitsky test.
Also, patients have leukocytosis and an increased erythrocyte sedimentation rate. This is revealed through the study of blood taken for a general analysis. A biochemical study confirms the presence of creatinine, cholesterol and residual nitrogen in it.
By the way, patients are also often referred for ultrasound of the renal vessels and ultrasound. A biopsy is indicated only in particularly severe cases, when the listed diagnostic methods do not give accurate results.
Drug therapy
Now you can talk about what drugs you need to take to eliminate the symptoms and treat glomerulonephritis in adults.
Generally, doctors prescribe the following medicines:
- Wobenzym. Immunomodulatory and anti-inflammatory agent, which is based on enzymes (protein molecules) of animal and vegetable origin. Taking this drugis aimed at reducing the number of immune complexes in the body, normalizing the permeability of the vascular walls and regulating the adhesion of blood cells.
- "Canephron N". This is a phytopreparation, a diuretic of plant origin. It has several actions at once - antimicrobial, diuretic, anti-inflammatory and antispasmodic.
- Metipred. Glucocorticosteroid of synthetic origin, which has an immunosuppressive, anti-allergic and anti-inflammatory effect. Also, the drug reduces the amount of globulins in plasma, increases the synthesis of albumin in the kidneys and liver, normalizes carbohydrate metabolism, increases the resistance of the cell membrane to the action of various damaging factors.
Of course, this is not the whole list of drugs indicated for use. However, it should be noted that only a nephrologist, who treats glomerulonephritis, can prescribe therapy.
The doctor's clinical recommendations are based on the results of the diagnosis, and therefore do not raise doubts. But self-medication and the decision to independently prescribe any drugs for oneself can be fraught with complications and other he alth problems.
Principles of nutrition and prohibitions
Talking about the symptoms of glomerulonephritis in adults and the treatment of this disease, it is necessary to talk about what kind of diet a person who is faced with this disease should follow.
In an acute form, nutrition should ensure unloading of protein metabolism. Need to make a dietso that the outflow of urinary fluid is maximized, and blood circulation and other metabolic processes are accelerated.
It will be necessary to reduce the energy value of the daily menu to 2200 kilocalories and reduce the intake of foods containing carbohydrates and fats. Food should contain as many minerals and vitamins as possible. But the amount of liquid drunk per day will have to be significantly reduced.
Also, while following a diet for glomerulonephritis, you need to give up the following products:
- S alt and all food containing it. Including breads, cheeses, confectionery and flour products, etc.
- Products with artificial ingredients.
- Out-of-season vegetables (they contain nitrates).
- Decoctions of legumes.
- Rich strong broths.
- Lamb, duck, pork, goose.
- Canned food, smoked meats.
- Sausage.
- Baked and stews that have not been precooked.
- Sour cream, lard, animal fats and cream.
- S alted and smoked fish.
- Caviar.
- Canned fish.
- Marinated, s alted and pickled vegetables.
- Shop-bought sauces and condiments.
- Everything is spicy.
- Radish, onion, legumes, garlic, radish, sorrel, spinach, mushrooms.
- Mineral waters with sodium bicarbonate composition.
- Cocoa, tea and coffee.
In addition to the above, you will also have to give up allergens, which include many berries and citrus fruits.
Allowed Foods
Continuing to discuss the principles of the diet shown for glomerulonephritis, it is worth considering the list of those products that can be included in the diet.
So, the menu should be based on the following products:
- Sweet pastries and bread without s alt.
- Lean meat (turkey, chicken) pre-cooked before final cooking. You can also make stuffing. But it also needs to be boiled. Then you can stuff vegetables with it, make cabbage rolls, casseroles or pancakes with it.
- Low-fat fish.
- Vegetable sauces, low-fat sour cream, tomatoes, milk or onions.
- Cumin, parsley, dried dill.
- Soups with vegetable broth or water. You can add cereals, pasta, onions (but after boiling). Borscht, beetroot soup and cabbage soup are allowed.
- Pasta and cereals. You can make puddings, cutlets, pilaf, casseroles from them.
- Yogurt, curdled milk, low-fat milk (up to 400 ml per day).
- Eggs, 2 maximum. You can boil them soft-boiled or make omelettes.
- Apricots, apples, watermelon, peaches, bananas, nectarines, melon, figs, strawberries.
- Kissels, fruit and berry purees, compotes, jelly, jams.
- Rosehip infusion, freshly squeezed juices, tea with sugar and lemon.
- Marshmallow, popsicles, honey, marshmallow, caramel.
Based on the allowed products, you can create a varied menu. So a person diagnosed with glomerulonephritis should not worry about whether his diet will be complete.
Folk remedies
With glomerulonephritis, the clinical recommendations listed above must be observed. And drug treatment in combination with proper nutrition is usually enough to restore he alth, but many decide to resort to folk remedies. And therefore it is worth telling about them in the end.
Here are some simple recipes:
- Parsley seeds (25 g), hop cones (10 g), hawthorn and motherwort (20 g each) mix and pour boiling water (300 ml). For half an hour send to a water bath. Then strain. Drink three times a day for 1 tbsp. l.
- Peeled and washed oats (5 tablespoons) pour 1 liter of milk. Boil it until tender over low heat and take 100 g three times a day.
- Catchment (2 tablespoons) pour boiling water (250 ml) and cook for 5 minutes over high heat. Strain. Drink the resulting volume per day in three divided doses.
- Crushed burdock root (4 tablespoons) pour 1 liter of boiling water and send to a small fire. Hold until half of the water has evaporated. Then remove the decoction, strain, and then add honey (2 tablespoons). Drink three times a day for 0.5 cups, and before going to bed - one whole.
In general, any herbs that have antimicrobial and anti-inflammatory properties are suitable for the treatment of glomerulonephritis. Among them are pharmacy chamomile, plantain, calendula, wild rose, oak bark, St. John's wort, yarrow, sage, birch buds, sea buckthorn branches.
The main thing is not to get carried away with infusions and decoctions. Their intake in an uncontrolled amount can also adversely affect he alth, as well asdrug abuse.
