Glomerulonephritis: symptoms, treatment, consequences, causes

What it is? Glomerulonephritis is an immunoinflammatory disease of the kidneys with a predominant lesion of the glomerular capillaries.

Allocate a chronic and acute form of the disease.

Chronic glomerulonephritis, as a rule, leads to the development of chronic kidney failure.

Prevalence of the disease

Acute glomerulonephritis is the second most frequent inflammatory kidney disease. They are more often affected by children over the age of two and adolescents, in boys, the disease is more common.

Reasons for

Why does glomerulonephritis develop and what is it? Isolate infectious and non-infectious causative factors glomerulonephritis. A predominant role in the development of the disease is streptococcus group A.

Etiological factors can also become the antigens of pneumococcus, staphylococcus, hepatitis C and B viruses, Coxsackie, infectious mononucleosis, influenza. Often the disease develops after a recent infection of the respiratory tract( tracheitis, angina, sinusitis, laryngitis, etc.).

Non-infectious causes of the disease include insect bites, allergic reactions, vaccination. All these factors are starting. The main importance in the development of glomerulonephritis belongs to immunological disorders. As a result of an inadequate immunological reaction, antigens bind to antibodies and in the form of immune complexes are deposited in the renal glomeruli.

Immunocomplex inflammation first develops. Then, autoantibodies are started to develop against their own glomerular antigens, that is, the inflammation acquires an autoimmune character.

Symptoms of glomerulonephritis

The clinical picture of the disease includes several syndromes: edematous, urinary and hypertonic. The first signs of glomerulonephritis usually appear 7-14 days after the infection.

Glomerulonephritis, the main symptoms of which are edema, which are localized mainly on the face in the eyelid region, but can also spread to the entire body. This condition is supplemented by other signs:

• increase in blood pressure;
  
• change in the nature and volume of urine;
  
• blunt low back pain.

Edema is caused by acute fluid retention and a large loss of protein. An important sign of the disease is a decrease in the amount of urine up to anuria. The liquid given out by the kidneys in color resembles meat slops because of massive hematuria. High hypertension can lead to acute left ventricular failure.


With favorable development, the symptoms of glomerulonephritis disappear after 3-4 weeks, and recovery occurs. In children, full recovery occurs in 98% of cases, and in 40% of adults, the disease becomes chronic.

Diagnosis of glomerulonephritis

Diagnosis of the disease is based on the analysis of characteristic complaints and clinical symptoms. The connection with the transmitted respiratory tract infections is taken into account. To clarify the diagnosis, laboratory and instrumental studies are carried out.

Laboratory methods for the diagnosis of glomerulonephritis:

• blood test( increased number of leukocytes predominantly of the neutrophilic series, left shift of the leukocyte formula, increased ESR);
  
• blood biochemistry( reduction of total protein, nonspecific signs of inflammation, hypercholesterolemia, increase in the amount of creatinine and urea, fibrinogen, prothrombin index);
  
• blood test for antibodies to hepatitis virus;
  
• determination of antibodies to streptococcus( anti-streptolysin-0 and antistreptokinase) in the blood;
  
• immunogram( increase in the number of immune complexes, other changes);
  
• urine analysis( presence of protein, erythrocytes, cylinders);
  
• urine tests for Reberg, Zimnitskiy, Nechiporenko( oliguria, predominance of nocturnal diuresis, erythrocyturia, proteinuria, leukocyturia).

Instrumental studies are also performed:

• ultrasound scan of the kidney,
  
• excretory urography,
  
• kidney biopsy( to clarify the morphological variant of the disease);
  
• ECG.

If a glomerulonephritis is suspected, an oculist, an otolaryngologist, a dentist should be consulted to identify a foci of infection and to diagnose changes in the fundus in hypertensive syndrome.

Treatment of glomerulonephritis

First of all, the basis of treatment of glomerulonephritis consists of several components. They must be adhered to without fail, so that therapy can be effective.

1. 1) Mode;
   
2. 2) Diets;
   
3. 3) Medical treatment;

Mode

With high arterial hypertension and massive swelling is mandatory bed rest. As soon as the symptoms of the disease begin to subside, the regime is expanded to prevent osteoporosis.

Diet

With glomerulonephritis, a diet with a reduced amount of protein, salt and liquid is prescribed. Strictly taken into account the amount of injected fluid and excreted urine.

Drug therapy

From medicamentous agents for the treatment of glomerulonephritis the following are used:

• glucocorticoids( adrenal hormones with pronounced anti-inflammatory effect);
  
• cytostatics;
  
• non-steroidal anti-inflammatory drugs,
  
• disaggregants and anticoagulants( heparin, quarantil);
  
• antibiotics( with post-streptococcal glomerulonephritis);
  
• immunomodulators and vitamins;
  
• diuretics( furosemide, veroshpiron, hypothiazide);
  
• antihypertensives( with severe arterial hypertension).

If the disease has a severe course with intoxication, it is possible to use extracorporeal methods of blood purification: hemodialysis, plasmapheresis or hemosorption.

Consequences of glomerulonephritis of the kidneys

The main complications of glomerulonephritis include:

• acute kidney failure;
  
• nephrotic eclampsia;
  
• acute left ventricular heart failure.

Acute kidney failure develops as a result of a sharp decline in their functions. The cause of this complication is a violation of the blood supply to the kidney tissue because of the large number of immune complexes that have settled in the capillaries of the glomeruli. OPN manifests anuria( daily urine volume is less than 100 ml), massive swelling, intoxication of the body and violation of water-electrolyte metabolism.


Acute left ventricular failure develops due to volume overload of the heart. It manifests itself as a cough, wheezing, wheezing, foamy sputum. As a result of high hypertension, pulmonary edema develops. These complications mainly occur in severe forms of glomerulonephritis.

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