For what and what tests should glomerulonephritis take
Glomerulonephritis is a disease of an immune-inflammatory nature, in which the kidney glomeruli are mostly affected and in the course of the disease tubules and interstitial tissue are involved.
Classify the primary form of pathology that occurs one to three weeks after the effect on the body of infectious and non-infectious factors, as well as a secondary form that develops against a background of different diseases.
Glomerulonephritis is considered the most common pathology that occurs in childhood and provokes the formation of kidney failure and early disability. In its prevalence among renal pathologies of childhood, the disease is second only after infections in the urinary tract. Analyzes with glomerulonephritis confirm the severity of the lesion.
The acute form of glomerulonephritis can occur in a person regardless of age, but in most cases in individuals under 40 years of age.
Clinical signs of the disease
At the first stages of the development of the disease, many patients complain about the puffiness of the face, skin blanching, decreased diuresis, clouding of urine and a moderate increase in blood pressure. Sometimes there are vague pains in the abdomen and lower back, general health deteriorates, appetite disappears, headache and vomiting develop. In the subsequent week of development of pathology, there is an increase in peripheral edema, often cavities are formed, the increase in arterial pressure is maintained and increased, while the eye fundus is not altered at the same time.
With a favorable course of the disease or cyclical development, as a rule, at the end of the second and third week, the symptoms regress to complete elimination. First of all, it concerns hypertension and puffiness. In addition, blood and protein in the urine with glomerulonephritis ceases to be detected. Elimination of the urinary syndrome and restoration of the kidneys can sometimes last for three to six months. If some signs of the disease persist for longer than six months, it is customary to talk about a protracted course of pathology, and longer than twelve months - about the transformation of pathology into a chronic form.
At the first stages of development, the acute form of glomerulonephritis is manifested by the following symptoms:
- Acute nephrotic syndrome - increased pressure, swelling and a characteristic color of urine with glomerulonephritis.
- Isolated urinary syndrome - the presence of protein and blood in the urine, but without accompanying increased blood pressure and development of edema.
- Nephrotic syndrome - the formation of edema, severe proteinuria. Initially, there is a risk of acute cardiac and renal insufficiency.
Diagnosis of the disease
The diagnosis of acute form of glomerulonephritis is based on the unexpected onset of pathology under the influence of infectious and non-infectious agents, as well as on the basis of manifestations of the disease - puffiness, high blood pressure and urinary syndrome.
Differential diagnosis of glomerulonephritis is carried out in the following cases:
- With the next exacerbation of the chronic course, which is characterized by damage for one year or more, disruption of the kidneys.
- In the development of pyelonephritis, which is characterized by a stable and pronounced neutrophilic leukocyturia and its characteristic manifestations.
To determine whether the body is affected, urine tests should be performed with glomerulonephritis. The characteristic diagnostic signs of glomerulonephritis are:
- The presence of blood in the urine, while it acquires a slightly reddish hue or takes a dark brown or even black color. With a weak hematuria, the color of urine does not change. At the very beginning of the disease, fresh erythrocytes predominate, and subsequently they are mainly leached out.
- The presence of protein in the urine is proteinuria. Usually it remains moderate and does not last for two to three weeks.
- When conducting a microscopic examination of the urine sediment, the presence of granular and hyaline cylinders is revealed, and in case of severe hematuria, erythrocyte cylinders.
- Endogenous creatinine clearance is being tested, which helps to establish impairment of kidney function.
- Zimnitsky's test allows to establish a decrease in diuresis, as well as nocturia. The high density of urine makes it possible to assume that the concentration properties of the kidneys persist.
- In the blood, the concentration of residual nitrogen and urea increases, and cholesterol levels also increase.
- Also, blood tests are characterized by leukocytosis and a high rate of erythrocyte sedimentation.
- In doubtful situations, a kidney biopsy and a subsequent morphological examination of the resulting material are organized.
The treatment of
pathology Treatment of acute form of glomerulonephritis includes the following steps:
- Compliance with the day regimen - all patients with this diagnosis should be on inpatient treatment and comply with bed rest.
- Compliance with the diet under number 7.
- Etiologic or otherwise anti-streptococcal therapy.
- Hormone therapy, as well as treatment with non-hormonal drugs, suppressing the work of immunity, anti-inflammatory therapy.
- Symptomatic therapy - removal of puffiness and lowering blood pressure.
- Organization of treatment of complications.
- Sanatorium treatment.
- Registration in the dispensary for two years.
When organizing the treatment of the chronic form of glomerulonephritis, the same procedures are carried out, in particular, this is typical for periods of exacerbation. Also, there are some contraindications for glomerulonephritis, namely, prolonged stay on the legs and excessive physical labor are prohibited.