What does a diagnosis of glomerulonephritis mean? This term is called inflammation of the kidneys, in which their main structure - the glomerulus - is damaged due to disturbances in the work of one's own immunity. Symptoms of glomerulonephritis usually appear after some previous diseases (especially streptococcal tonsillitis), hypothermia, against the background of autoimmune and rheumatic diseases, less often due to toxic causes. Both kidneys are affected at once.
How does a kidney work?
This paired organ has a very intense blood supply. It is in the kidney that many vessels are interwoven and work so harmoniously that they have been called the “wonderful network”. Such an active blood supply is necessary in order to perform the main function - to filter the blood every second, to separate unnecessary components and a certain amount of water and excrete them in the urine, which is why the organ is called "plasma ultrafiltrate". So, per day, the kidneys “process” about 150 liters of plasma, and as a result, about 1.5 liters of filtrate is obtained (normally, in children and adults, it should form at least 1 ml / kg of body weight per hour, but not more than 3 ml/kg/h).
There are two main points in the work of the kidney:
1) Filtration, in which the glomerulus participates. Blood passes through a specific "sieve". As a result, proteins, cellular elements and some of the water return to the bloodstream, and the substances dissolved in the plasma go further into the tubules of the nephron.
2) Reverse suction. Through this mechanism, the blood is repeatedly processed in the tubules, and a very small percentage of the original amount of fluid, some of the necessary electrolytes, nitrogen, toxic substances and drugs that were dissolved in the plasma, enters the urine.
In addition to filtering the blood, the kidney is also involved in the production of substances necessary to lower blood pressure, as well as substances that stimulate the formation of red blood cells.
What causes symptoms of glomerulonephritis?
- Streptococcal infection: lacunar or follicular tonsillitis (most often), pharyngitis, skin lesions with pustules - impetigo. In this case, the immune system “remembers” what the antigens of the enemy streptococcus look like, and since the structure of the kidney tissue resembles this bacterium, the glomerulus of the renal nephron is also affected.
- Other infections:
- bacterial: sepsis, pneumonia, endocarditis caused by coccal flora, meningococcal, typhoid fever;
- viral: hepatitis B, mumps, chickenpox, enterovirus;
- diseases caused by protozoa: malaria, toxoplasmosis.
3. The introduction of various immune preparations, sera, vaccines. In this case, the immune system "reacts" to foreign proteins (these drugs are made on the basis of proteins from various animals, such as horses). The "antigen plus own antibody" complex is deposited near the glomerulus of the kidney and damages it.
4. Systemic diseases: periarteritis nodosa, lupus, Goodpasture's syndrome, vasculitis. In these cases, antibodies are often formed against the main component of the kidney glomerulus - the membrane.
5. Some birth defects of the immune system.
6. Violation of the blood supply to the kidney in conditions of hypothermia and high humidity.
Symptoms of glomerulonephritis
The disease can be acute, subacute (the most malignant) and chronic. Each type is based on more or less severe damage to the glomeruli (sometimes to other parts of the kidney), as a result of which both protein and blood cells enter the urine. The protein itself holds fluid in the bloodstream. When there is less of it, there is little that keeps it in the vessels, it goes into the tissues. This is how swelling occurs. In addition, proteins such as globulins are released, making the body more susceptible to infections.
Due to the loss of blood cells in the urine, anemia develops. In addition, the mechanism of stimulation of the formation of new red blood cells also suffers. The process of producing a substance that lowers blood pressure is also disrupted.
Acute glomerulonephritis symptoms are different, varying degrees of severity. They appear 1-2 weeks after vaccination or an infectious disease, maydevelop rapidly, may gradually. The main symptoms of glomerulonephritis are:
- weakness, headache, nausea, loss of appetite;
- increased body temperature;
- decrease in the amount of urine;
- the appearance of aching pain in the lower back on both sides;
- urine can be red, brown (“color of meat slops”), sometimes the change in shade is imperceptible, but the results of the urine test indicate that there are a large number of altered red blood cells;
- also with a general urine test, they can reveal that there are protein, leukocytes in large numbers, cylinders;
- the face and lower legs become swollen, while the swelling can be both dense and soft, easily displaced; there is a tendency to spread them to the stomach, lower back;
- if the protein loss is large, the fluid sweats into the pleural cavity, and into the abdominal cavity, and into the heart bag: shortness of breath increases, it is difficult to move, pulmonary edema may develop;
- blood pressure rises to different numbers;
- skin is pale, dry;
- hair is dull, brittle.
There may be a different combination of symptoms, but usually the disease cannot do without the appearance of blood in the urine, a decrease in its amount and swelling. Very rarely, the disease has no pronounced manifestations. A person does not go anywhere until such time as a large number of glomeruli cease to function.
If acute glomerulonephritis cannot be overcome within a year, then it is considered that it has passed into chronicshape. Contribute to this:
- foci of chronic infection (chronic tonsillitis or sinusitis, caries);
- existing allergic and autoimmune diseases;
- frequent SARS during this period.
A chronic process can also manifest itself with a different combination of symptoms:
- only blood in the urine, no edema or increased pressure;
- there is also hypertension, and edema, and the release of a large amount of protein into the urine;
- the main symptom is an increase in pressure, there is almost no edema, and changes in the urine are almost invisible "by eye";
- you can only notice changes in the urine if you pass it for analysis, there are no edema and no increase in pressure.
At the same time, if some factor provokes an exacerbation of the chronic process, then the symptoms will be more pronounced, as in acute glomerulonephritis.
Treatment of glomerulonephritis
Therapy at first is carried out only in a hospital. A person is prescribed bed rest and a s alt-free diet with a very small amount of proteins and fluids. If there is data confirming that the cause of the disease is a bacterial process in the body, then the focus of infection is sanitized, antibiotics can be prescribed. The symptoms of glomerulonephritis and the treatment depend on it.
The following drugs are also used for therapy:
- glucocorticoid hormones, as well as cytostatics that stop the self-destruction of the kidneys;
- drugs that improve blood flow in the kidneys;
- diuretics;
- antihypertensive drugs;
- if necessaryprotein preparations, erythrocyte mass (with low hemoglobin) are administered intravenously.
