Glomerulonephritis is a concept that refers to a group of immune diseases of the kidneys that are characterized by primary glomerular damage. The disease is characterized by a tendency to progression. In the absence of proper treatment, the symptoms of glomerulonephritis lead to nephrosclerosis, provoke the development of chronic renal failure syndrome.
General information about the disease
Humanity has known about glomerulonephritis for a very long time. This disease was first described in 1827. This work was carried out by the English doctor R. Bright. At the beginning of the next century, a classification of glomerulonephritis by disease progression appeared. However, this did not mean that the disease was carefully studied by specialists. The active phase of the study and the compilation of clinical recommendations for glomerulonephritis began in 1951 with the development of a kidney biopsy technique.
The cause of the symptoms lies in the entry of harmful microorganisms into the body. The disease is caused by streptococci, staphylococci, enterococci, diplococci, etc. Glomerulonephritis develops after previous streptococcal infections (tonsillitis, scarlet fever, pharyngitis, bronchitis, pneumonia, etc.)
Why is the disease called glomerulonephritis (according to ICD-10 - N00, N01, N03, N18)? The term comes from the word "glomerulum." It is borrowed from the Greek language. This word is translated as "glomerulus." This is the main part of the kidney tissue. To explain what a glomerulus is, start with a nephron. This is a structural unit of the kidney. There is an accumulation of small blood vessels in the nephron. All of them are intertwined and resemble a glomerulus in appearance. It is this structure that is affected, causing glomerulonephritis symptoms.
Glomerulonephritis
There are several classifications of the disease. In accordance with the nosological principle, primary and secondary glomerulonephritis is isolated. In the first embodiment, the cause of the pathological condition is unknown, and in the second, the disease develops due to systemic diseases, liver diseases, and the use of certain drugs.
Given the course of the disease, glomerulonephritis is divided into:
- On the sharp form. With the correct and timely treatment of glomerulonephritis, recovery occurs.
- On subacute form. It is characterized by a turbulent, often malignant course. With such glomerulonephritis, the development of acute renal failure is possible.
- On a chronic form. This type of disease is characterized by a progressive course with an outcome in chronic renal failure.
Acute glomerulonephritis, in turn, is divided into post-streptococcal and post-infectious (classification by etiology), as well as epidemic and sporadic (classification by epidemiology). Chronic glomerulonephritis also has several forms:
- latent - changes are detected only in the urine of a sick person;
- hematuric - the presence of edema and arterial hypertension;
- hypertonic - there are changes in the urine, arterial hypertension;
- nephrotic - nephrotic syndrome is detected , there is no arterial hypertension ;
- mixed - with this form, nephrotic syndrome can be combined with arterial hypertension, hematuria, azotemia.
Symptoms and course of acute glomerulonephritis
The acute form of the disease in many people begins with a simple sore throat. At first the throat hurts, the temperature rises. Unpleasant symptoms torment several days. Then comes recovery. It seems that the disease has receded, but then angina replaces acute glomerulonephritis (after about 1-2 weeks). It makes itself felt by high temperature, a deterioration in well-being. The amount of urine excreted decreases, and also it acquires a reddish hue. Swelling quickly appears. Also, blood pressure rises, headaches begin to torment.
Edema is one of the important symptoms of glomerulonephritis. A red tinge of urine may not be observed, but edema occurs in 70–90% of cases. Very often they appear on the face. They indicate that the kidneys do not cope with the function of urine output. Very much swelling is noticeable in the morning. By evening, they usually decrease. It is important to note that swelling is not always visible. Sometimes fluid accumulates in the pleural, abdominal, pericardial cavities. Due to such latent edema, body weight is significantly increased.
Experts recommend that people after angina and other diseases take urine for examination. In adults, the picture of glomerulonephritis is not too bright. The disease is sometimes indicated not by symptoms, but by changes in analyzes. Mostly in children and adolescents, the acute form of glomerulonephritis proceeds with a rapid onset.
Features of chronic glomerulonephritis
The chronic variety of the disease is divided into several forms, which were mentioned above. Each of them is characterized by certain symptoms of glomerulonephritis. For example, a mild urinary syndrome is inherent in the latent form. A person may not be aware of the presence of an ailment. As a result, the disease will progress for a long time - maybe 10, or maybe 20 years. In the end, it will lead to the development of uremia. Due to impaired renal function, the body will be poisoned by protein metabolism products.
But for example, a hypertonic form. In most cases, it develops from the latent form of acute glomerulonephritis. The most striking sign of the disease for a long time is pronounced hypertension. During the day, the pressure varies greatly, but it still does not reach high values. Due to changes negative for the body, hypertrophy of the left ventricle develops.
Periodic relapses and remissions are characteristic of all forms of a chronic disease. Exacerbations of glomerulonephritis are most often recorded in the fall and spring and after the ingestion of harmful microorganisms that provoke angina and other diseases. Any form of chronic glomerulonephritis requires treatment. The onset of remission does not mean that a miracle happened, and recovery has come. With the disease, specialist assistance is needed. If untreated, glomerulonephritis passes into the final stage - a secondary-wrinkled kidney.
Diagnosis of the disease
Diagnosis begins with a survey of the patient and clarification of complaints. The doctor’s suspicion of glomerulonephritis occurs when the patient begins to complain of a headache, dark urine, and the presence of edema. Some people talk about the presence of nausea, vomiting. The doctor who suggested glomerulonephritis, the medical history must be evaluated on a medical record. The document may contain indications of an infection several days or weeks before the exacerbation.
After the survey, a physical examination is performed. It allows you to detect signs of glomerulonephritis - swelling on the face, legs, increased blood pressure, etc. Laboratory and instrumental studies are also being performed:
- general blood analysis;
- biochemical blood test;
- Analysis of urine.
The main diagnostic measure for suspected glomerulonephritis is a kidney biopsy. In this procedure, the indication for conducting is the need to clarify the morphological form of the disease and conduct differential diagnosis. Additionally, ultrasound can be prescribed. Thanks to this diagnostic study, doctors exclude focal kidney disease, urinary obstruction.
Power Features
With glomerulonephritis, as with other kidney diseases, the diet is one of the most important therapeutic agents. The acute form of this ailment necessitates a reduction in the amount of fluid used (up to 600-800 ml per day). In the early days, adhere to a fruit and sugar diet. With glomerulonephritis, milk-vegetable food is subsequently eaten. It is allowed to eat dishes of potatoes, vegetables, cereals, pasta without adding salt. Recommended cooking methods are boiling, stewing, mashed potatoes.
In chronic glomerulonephritis, they adhere to a sparing regimen. First of all, they limit the addition of salt to food. The permissible daily dose of this ingredient is from 2 to 4 g. Experts also recommend that for chronic glomerulonephritis periodically for some time, completely exclude salt from your diet - for about 1-1.5 months. Following this advice avoids exacerbations.
In chronic glomerulonephritis, patients strictly monitor the water balance. The volume of fluid consumed in 24 hours should be equal to the volume of urine excreted and slightly exceed this indicator by about 300-500 ml. When edema occurs, they switch to fasting days. They are effective if held a couple of times a week. At such times, adhere to the apple or potato-apple diet.
Sample menu for the day
What can be the nutrition for the disease in question? Following a diet with glomerulonephritis, people for breakfast cook cereals in milk, prepare pasta, eggs. From drinks it is allowed to drink coffee with milk, tea with sugar, tea with milk. Particular attention should be paid to eggs. They do not fry with glomerulonephritis. Methods of their preparation - soft-boiled (cooking for 3 minutes) and in a bag. In the latter case, the eggs are simply broken into boiling salted water and cooked for 2 minutes under the lid. If you want to cook fried eggs, you just need to break the eggs into a container and put it in a bowl with boiling water. After a while, the mass will curl up and turn into fried eggs.
During lunch, as a first course, dairy, vegetable, cereal, and potato soups (vegetarian options) are served on the table. The second course can be stewed potatoes, vegetable purees, cereal casseroles, cabbage rolls. They use fruit for dessert, and drink compotes, juices, and jelly from drinks. An afternoon snack with glomerulonephritis is a small snack. You can satisfy your hunger with fruit, juice, milk, kefir, baked apples. For dinner, boil potatoes, make casseroles, bake pancakes, rolls, cheesecakes.
Disease treatment
Therapy is prescribed by a doctor after taking tests for glomerulonephritis and identifying the form of the disease. In the acute course of a sick person, they are sent to a hospital, bed rest, a special diet are prescribed. In a hospital, treatment sometimes takes quite a long time. With a mild form, people have to lie from 2 to 4 weeks, and with more severe ones, for several months.
In treatment, doctors sometimes use an etiological approach, i.e. prescribe such drugs that should eliminate the cause of the disease:
- with nephritis associated with subacute infectious endocarditis, and with post-streptococcal nephritis, antibiotics are prescribed;
- with virus-associated glomerulonephritis, antiviral drugs are indicated, etc.
However, far from all cases, an etiological approach can be applied. Most often, it is necessary to start therapy with a pathogenetic treatment aimed at certain processes of pathogenesis (inflammation, immune processes). One of the groups of drugs related to pathogenetic treatment is glucocorticoids. They have anti-inflammatory and immunosuppressive effects.
Prognosis for glomerulonephritis
The outcome of the disease depends on several factors - on the morphological variant of glomerulonephritis, the frequency of exacerbations, the development of chronic renal failure. In acute form, the prognosis is favorable. However, it is worth remembering that only with treatment does recovery come. Incorrect, untimely or completely absent therapy increases the likelihood of the progression of the disease and the transition of the acute variant to the chronic one.
With chronic glomerulonephritis, things are much more complicated. The prognosis depends on the types of this disease. With the latent form of chronic glomerulonephritis, the prognosis is favorable, with hypertensive - serious, and with a mixed - unfavorable.
Preventative measures
Prevention of acute glomerulonephritis includes the prevention and early treatment of acute infectious diseases, the elimination of focal infection. Experts recommend that people temper the body, avoid prolonged and sharp hypothermia of the body, do not work on such work, which is associated with being in cold conditions, physical stress. After treatment, it is not worth planning a pregnancy for the next 3 years. It is advisable to periodically undergo medical examinations, take urine for analysis, monitor your blood pressure.
For the prevention of chronic glomerulonephritis, similar prophylactic measures have been established. Necessary
- timely eliminate the foci of infection in the body;
- treat intestinal infections;
- avoid overcooling the body and exposure to moist air;
- be under medical supervision;
- not to go on long trips, not to get a job with night shifts, not to work with harmful substances;
- regularly go for spa treatment;
- eat properly;
- to refuse from bad habits.
In general, you should lead a healthy lifestyle.
In conclusion, it is worth noting that you need to be more careful about your body, value your health and life. Only with this approach, as well as with timely medical attention and adherence to its clinical recommendations, glomerulonephritis can be avoided, like any other disease.