Jun 10, 2018
Chronic glomerulonephritis is a group of renal diseases characterized by constant progressive inflammatory, sclerotic and destructive lesions of the kidney tissue followed by sclerosis and frequent development of chronic renal failure.
Chronic glomerulonephritis, as a rule, is a primary chronic disease, ie it develops independently, without previous damage to the kidneys. The disease has a clear hereditary predisposition. As the factors triggering the onset of the disease, the following can play a role: irrational drug therapy( long-term administration of toxic drugs for the kidneys), chronic foci of infection( carious teeth, chronic tonsillitis, adenoids), chronic viral infections( hepatitis B), excessive body foreign loadssubstances( infections, repeated injections of immunoglobulins, improper vaccination).
At the heart of the disease is a violation of the immune system. Normally, kidney tissue is delineated from human blood, and renal proteins are "foreign"
for the body. In the event of a breach of the integrity of this barrier, which separates the blood from the kidney tissue, these foreign kidney proteins( antigens) enter the bloodstream. Damage to the barrier can occur under the influence of various factors, for example under the influence of drugs, various toxins and viruses. Also, the barrier can be disrupted if the kidneys are underdeveloped. The consequence of this is the development of antibodies to the body's own proteins( autoantibodies), which cause damage to the kidneys. In addition, chronic glomerulonephritis can develop as a result of impairments in the function of the immune system, in which an autoimmune process is possible to intact renal tissue.
The manifestation of the disease is determined by the form of chronic glomerulonephritis.
With a hematuric form of the disease, the onset of the disease is often difficult to establish( a small amount of blood in the urine is often detected accidentally).Such people usually do not worry about anything, blood pressure more often remains within the norm( increased only in 7-10% of cases), temporary swelling may appear;disorders of urination and signs of intoxication are absent. Sometimes there is a pallor of the skin, pain in the abdomen or lower back, fatigue, headache. The main sign of the disease is persistent presence of blood in the urine( hematuric syndrome), the degree of which can vary. The function of the kidneys can not be disturbed.
Osteo-proteinuric form of chronic glomerulonephritis often has an acute onset. After the passed respiratory infection, tonsillitis, vaccination, cooling, and sometimes outwardly, all signs of acute kidney damage with massive excretion of protein in the urine appear. The main manifestations of the disease are: massive excretion of protein in the urine( proteinuria), edema of varying severity, a decrease in serum protein( hypoproteinemia), an increase in blood lipids( hyperlipidemia).It is possible to increase blood pressure and the appearance of nitrogenous slags in the blood, which comparatively quickly disappears on the background of treatment.
The disease proceeds long, wavy. For a long time, the excretion of metabolic products( nitrogen compounds) by the kidneys is not disturbed, but chronic renal failure eventually develops.
Mixed form of chronic glomerulonephritis usually begins with acute nephritis, but is difficult to treat. Pain in the abdomen or in the lower back, urination disorders, the appearance of severe swelling, increased blood pressure, headache, dizziness, irritability or lethargy, visual impairment, sometimes facial paralysis, vomiting, decreased reflexes, impaired coordination of movements, convulsions are characteristic of this type. Arterial blood pressure significantly exceeds age standards. When examining the fundus, signs of damage are revealed as a result of high blood pressure. At laboratory research reveal changes in urine( blood, a large amount of protein), a decrease in the protein content in the blood and an increase in the lipid content. With this form of the disease, chronic renal failure develops in 1-2 years of the disease.
Treatment of chronic glomerulonephritis is prescribed individually, depending on the form and course of the disease, the presence and stage of renal failure, concomitant diseases and complications. Basic therapy includes diet, compliance with the regime, phytotherapy and treatment of foci of chronic infection( carious teeth, tonsillitis, adenoids).
The diet depends on the functional state of the kidneys. During the exacerbation of children with a hematuric variant of chronic glomerulonephritis, the diet is constructed in the manner prescribed for acute glomerulonephritis: they limit the amount of liquid, exclude table salt from the diet, and limit the amount of protein. With exacerbation in children with hematuric and mixed forms of flow recommend a salt-free protein diet( a daily amount of protein about 1 g / kg).Expanding the diet and increasing the amount of protein is slow to avoid exacerbations of the disease.
Bed rest is prescribed only in the acute period of the disease.
Phytotherapy can be carried out for a long time( months and years) and can include both infusions of individual herbs and various charges. The composition of the collection should include the following components: lavender spicery, black currant, white birch leaf, juniper fruit, common hop pine, Crimean rose petals, common bearberry leaves, cranberry leaf, plantain leaf, nettle nettle, cinnamon rose fruit, wild strawberry berries, shoots of horsetail field.
Drug treatment is prescribed only by the attending physician taking into account the type of glomerulonephritis, which is also determined only by the doctor.
Prevention of chronic glomerulonephritis includes the timely detection and treatment of chronic foci of infection( carious teeth, adenoids, chronic tonsillitis), adequate and timely treatment of acute glomerulonephritis, rational use of drugs that have toxic effects on the kidneys.
The prognosis for chronic glomerulonephritis depends on the form of the disease. But in most cases, chronic glomerulonephritis is a disease with steady progression, gradually leading to sclerosis of the renal tissue and the development of chronic renal failure.
Clinical follow-up for chronic glomerulonephritis is performed before the child is transferred to the supervision of an adult polyclinic. Examination by a doctor with measurement of blood pressure and urinalysis is carried out in the first 12 months after exacerbation 1 time per month, then in the absence of exacerbations - 1 time per quarter. Examination of the dentist, otolaryngologist, ECG is carried out once a half a year.
Drug therapy is prescribed depending on the shape and characteristics of the course of the disease.