Causes and symptoms of glomerulonephritis
What is Glomerulonephritis?
Glomerulonephritis is a kidney disease also called glomerular nephritis. It is characterized by inflammation of the glomeruli. The disease affects the glomeruli, affecting the tubules of the interstitial (interstitial) tissue.
According to its development, glomerulonephritis refers to infectious and allergic diseases. This combination of words suggests that the disease combines the formation of an infectious allergy and non-immune organ damage. However, there are also autoimmune forms of the disease, in which the kidney tissue is damaged by antibodies to its own organ.
Glomerulonephritis has been going on for 15 years. At the same time, there is no edema, blood pressure is low. For 10-25 years, kidney function is maintained, while the disease continues to progress and invariably leads to chronic failure. Glomerulonephritis occurs with different periods, exacerbations are replaced by remission. During remission, the patient does not complain about anything, only hypertension and urine analysis, which constantly signals the presence of glomerulonephritis, can speak of the disease, only a little less during remission. The disease worsens from hypothermia, from infections, from the use of alcoholic beverages. During the period of exacerbation, the symptoms are the same as in acute glomerulonephritis. The skin of a person with glomerulonephritis is usually dry.
- Glomerulonephritis symptoms
- Glomerulonephritis reasons
- Glomerulonephritis treatment
- Possible complications of glomerulonephritis
- Prevention of glomerulonephritis
Given the different forms of glomerular damage, one or the other symptoms of glomerulonephritis begin to predominate:
- The presence of blood in the urine (urine has the color of "meat slops");
- Swelling of the face (mainly the eyelids swell), feet and lower legs;
- High blood pressure;
- Scanty urine, thirst;
- Body temperature rises (rarely);
- Appetite disappears, nausea, vomiting, headache, weakness appear;
- Body weight increases;
- Shortness of breath
Often after a streptococcal infection (tonsillitis, tonsillitis, scarlet fever) after 6-12 days, acute glomerulonephritis may develop. Skin infections (pyoderma, impetigo) also contribute to the development of this disease.
However, the disease can develop from other infections - bacterial, viral, parasitic - or after antigenic exposure (serum, vaccines, drugs).
The following causes of glomerulonephritis are distinguished:
- Infections (tonsillitis, scarlet fever, infective endocarditis, sepsis, pneumococcal pneumonia, typhoid fever, meningococcal infection, viral hepatitis B, infectious mononucleosis, mumps, chickenpox, infections caused by Coxsackie viruses, etc.);
- Systemic diseases: systemic lupus erythematosus, vasculitis, Schönlein's disease, Henoch's disease, hereditary pulmonary-renal syndrome;
- Administration of vaccines, serums;
- Toxic substances (organic solvents, alcohol, mercury, lead, etc.);
Glomerulonephritis appears 1–4 weeks after the negative impact of the provoking factor.
Patients with acute glomerulonephritis are subject to compulsory hospitalization. The patient is shown bed or strict bed rest. It all depends on how he feels. This is because the patient's body must warm up evenly. Maintaining a stable temperature can optimize kidney function.
It will take about 14 days or even more to stay in the hospital. Sometimes patients are hospitalized for a month, or until the symptoms of the disease can be completely stopped. What matters is how the patient's body reacts to therapy.
After achieving remission, you need to abandon physical activity, prevent hypothermia or overheating of the body.
Table 7a is shown to all patients with glomerulonephritis. It involves limiting protein foods and salt. This will avoid the formation of persistent edema and prevent an increase in blood pressure.
Inflamed kidneys can react acutely to foods that are potential allergens. The menu should be dominated by dishes rich in potassium and fiber. This is especially true for patients receiving corticosteroid therapy.
Elimination of disease symptoms
If a person with glomerulonephritis has an increase in blood pressure and edema forms, then he is prescribed diuretics. They are not accepted for long.
Patients are prescribed drugs that strengthen blood vessels, drugs that nourish the kidneys and antioxidants.
Herbal remedies help to cope with edema with glomerulonephritis. Herbal treatment can reduce the drug load on the body.
If the disease was caused by bacterial flora and this was confirmed during the diagnosis, then the patient is prescribed antibiotics. Most often, antimicrobial therapy is required for patients who have had a sore throat or another infection, the causative agent of which was beta-hemolytic streptococcus. Inflammation of the kidneys in this case will act as a complication.
The drugs of choice are: Ampicillin, Ampiox, Penicillin or Oxacillin. They are prescribed 250,000 or 500,000 units 4 times a day. Medicines are administered intramuscularly. For glomerulonephritis, which is characterized by rapid progression, interferon is prescribed.
In acute glomerulonephritis, the glomeruli of the kidneys are attacked by their own antibodies. They are produced by the immune system. Thus, she can respond to a beta-hemolytic streptococcus infection. Sometimes the kidneys themselves become targets for antibody attack. Therefore, the treatment of glomerulonephritis involves suppressing the activity of the immune system with the help of immunosuppressants. They are included in different therapeutic regimens.
Reactive glomerulonephritis is treated with a pulse therapy regimen. The patient is injected intravenously with high doses of the selected drug during the day. Then it is reduced to standard values.
The drug of choice is Prednisolone. The daily dose is calculated based on the patient's weight (1 mg / kg). Then it is reduced to 20 mg per day. When the patient's state of health stabilizes, the drug is gradually canceled.
If therapy is carried out with cytostatics, then doctors most often use Cyclophosphamide (2 mg / kg) and Chlorambucil (0.1 mg / kg body weight). After reaching remission, drugs that suppress the immune system are canceled. Further treatment is reduced to taking herbal remedies.
Multicomponent treatment regimens for glomerulonephritis
Steinberg's scheme. The patient is administered 1000 mg of Cyclophosphamide 1 time per month intravenously for a year. Over the next 2 years, the drug is administered once every 3 months. On the 4th and 5th year of treatment, the drug is administered 1 time in 6 months.
Ponticelli's scheme. The patient is given pulse therapy with Prednisolone (1000 mg once a day). High dose therapy is continued for 3 days. Then, for another 27 days, the patient is offered 30 mg of the drug per knock. Over the next month, Prednisolone is alternated with Chlorambucil at 0.2 mg / kg per day.
Four-component treatment regimen. Within 60 days, Prednisolone is prescribed at 30 mg per day. Then the dose of glucocorticosteroids is gradually reduced until a stable remission is achieved. At the same time, a cytostatic chosen by the doctor is prescribed. The third component is Heparin (5000 IU 4 times per knock). He is appointed for a month. In the future, the patient is transferred to Aspirin. The fourth component is Dipyridamole at a dosage of 400 mg per day. Such a regimen is prescribed for patients with glomerulonephritis, which is characterized by rapid progression.
Normalization of the blood clotting process
Inflammation of the kidneys is accompanied by a violation of the blood clotting process. Platelets begin to clump together, forming clots. They lead to a deterioration in the nutrition of internal organs. To prevent their hypoxia, patients are prescribed antiplatelet agents and anticoagulants. The most commonly used are Heparin (20,000 IU per day), Dipyridamole and Pentoxifylline.
Video: answers to questions from surgeon Alexander Malko:
Possible complications of glomerulonephritis
Acute glomerulonephritis is dangerous for its complications. They develop especially often in patients with a reactive form of inflammation.
The patient may have such health problems as:
- Heart failure.
- Deterioration of vision, up to the development of complete blindness.
- Renal failure
- Renal encephalopathy.
If the patient's body does not respond to the therapy, he is prescribed plasmapheresis or blood transfusion. All patients who have undergone an acute form of glomerulonephritis are indicated for treatment in specialized sanatoriums. It is recommended to move to live in countries with hot climates. Increased sweating speeds up metabolic processes and improves kidney function. This will allow the urinary system to recover faster. Herbal medicine continues to be practiced even after reaching a stable remission.
Glomerulonephritis is a dangerous pathology. The faster the inflammatory process progresses, the harder it is to cope with it. Not only kidneys, but also other body systems suffer from glomerulonephritis. Therefore, when the first symptoms of the disease appear, you need to visit a specialist.
Prevention of glomerulonephritis
For the diagnosis and treatment of acute glomerulonephritis, it is very important to pay attention to urinalysis while the patient is feeling well.
There is no way to apply radical treatment for chronic glomerulonephritis, because the autoimmune process is not exacerbated. It is advisable to lie down more, avoid physical activity, not overcool, work in a dry, warm room, and while sitting, follow a salt-free diet (salt can be consumed up to two to three grams per day), food should be rich in vitamins and trace elements. Rehabilitation of foci of chronic infection is necessary.
Benefits will be provided by spa treatment in dry and hot climates. During an exacerbation, hospitalization is required. An aggravation can be considered a deterioration in urine analysis. During the period of exacerbation, the same treatment is used as for acute glomerulonephritis.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".