Glomerulonephritis: pathogenesis, clinical recommendations, symptoms, diagnosis and diet

Glomerulonephritis is an inflammatory disease in which small kidney vessels called glomeruli are affected. According to the etiology, manifestations, course of the disease and its outcome, several forms are distinguished.

What are they characterized by? What generally provokes the occurrence of this disease? What is the pathogenesis of glomerulonephritis? What symptoms indicate its presence? And how to cope with this ailment? This is worth telling in more detail.

Classification

The first step is to turn to the ICD-10. Glomerulonephritis, in accordance with the international classification of diseases, belongs to category N03. This code indicates chronic nephritic syndrome.

In accordance with this document, glomerulonephritis according to ICD-10 is as follows:

• Diffuse membranous: N0.2.
• Mesangial proliferative: N0.Z.
• Endocapillary proliferative: N0.3. 4.
• Mesangiocapillary: N0.5.
• Diffuse sickle-shaped: N0.3. 7.

The form of the disease a person is exposed to is revealed only in the process of conducting a detailed diagnosis. Because the external manifestations of the disease are nonspecific. Symptoms will be similar in both diffuse membranous and sickle-shaped glomerulonephritis.

The mechanism of the development of the disease

Now the pathogenesis of glomerulonephritis should be discussed. The development of this disease in all cases is associated with acute or chronic infection, which is localized in different organs and, usually, has streptococcal origin.

In rare cases, the cause of glomerulonephritis is chemical poisoning, vaccination or abuse of products containing preservatives.

The development of this disease begins with the formation of immune complexes in the kidneys or blood - antibodies that are associated with the surface antigens of a bacterial cell. Their level increases, and the number of complex proteins (C3-complements) decreases.

If a biopsy is performed at an early stage of glomerulonephritis, then glomerular damage from 80 to 100% will be detected in the test material. It is also possible to notice lumpy granular deposits along the basal membranes of the glomerular capillaries, consisting of the notorious SZ complement and immunoglobulin G.

Course of the disease

There are two main options:

• Cyclic (typical). It manifests itself as a stormy beginning and a significant severity of clinical symptoms.
• Acyclic (latent). This is an erased form of the disease, which is characterized by a gradual onset and weak severity of symptoms. It is more dangerous, unlike the previous one, since it is usually diagnosed late, and as a result leads to the fact that the disease takes on a chronic form.

What about acute glomerulonephritis. But, as mentioned earlier, very often it takes a chronic form. And in this case, the following options for the course of the disease are possible:

• Hypertensive. With this form of flow, urinary symptoms are very mild. Basically, the patient suffers from constantly high blood pressure.
• Nephrotic. Glomerulonephritis in this case is accompanied by a manifestation of pronounced urinary symptoms.
• Mixed. It is characterized by a combination of both of the above syndromes.
• Latent. A common form of the course of the disease is a chronic form. It is characterized by the absence of arterial hypertension and edema. Nephrotic syndrome is very mild.
• Hematuric. A difficult case, since the only symptom is the presence of red blood cells in the urine, and this can be detected only by passing this biomaterial for analysis.

Talking about the forms of the course and pathogenesis of glomerulonephritis, it should be noted that a relapsing course is characteristic of any variant. When an exacerbation occurs, all clinical symptoms completely repeat the first episode of the onset of the disease, or at least resemble it.

The likelihood of relapse, by the way, increases in spring and autumn. It is during this period that cases of infection with streptococcal infection are especially common. And if a person already once suffered one of the forms of glomerulonephritis, then relapse will occur 1-2 days after exposure to an irritant.

Symptoms

Since we are talking about the causes and pathogenesis of glomerulonephritis, it is necessary to list the signs by which the presence of this disease can be recognized.

The first symptoms come to light 1-3 weeks after the infection caused by streptococci. Most often it is tonsillitis, pyoderma and tonsillitis.

So, the presence of this disease, usually indicated by such symptoms:

• Urine discoloration. Its quantity increases, but the density decreases.
• Fever.
• Pain in the lumbar region.
• Light chills, worse over time.
• General weakness.
• Lack of appetite.
• Nausea.
• Headache.
• Swelling and pallor.

It should also be noted that urine with glomerulonephritis eventually turns pink or red. This is due to hematuria - the presence of blood in it.

This symptom can also have a different severity. Approximately 85% of patients develop microhematuria - in this case, the presence of red blood cells in the urine can be detected only by examining the biomaterial under a microscope. But in 15% of patients, macrohematuria is observed. In such cases, the urine may turn black or dark brown.

Hypertension (increased blood pressure) also becomes a common symptom. With a severe form of the disease, it lasts several weeks.

And it should also be noted that glomerulonephritis, the causes and symptoms of which are now in question, often causes damage to the cardiovascular system, as well as problems with the central nervous system and enlarged liver.

Complications

If a person does not pay attention to symptoms in time and does not consult a doctor, then he will have to face the consequences. As a rule, the following complications of glomerulonephritis develop:

• Pulmonary edema. The probability of its occurrence in people suffering from heart disease and hypertension.
• Eclampsia. It is characterized by a sharp increase in pressure, bouts of epilepsy, convulsions and a hypertensive crisis.
• Intoxication of the whole organism (uremia).
• Acute heart failure. Occurs in 1% of cases.
• Acute renal failure. Occurs in 3% of cases.
• Intracerebral hemorrhage.
• Hypertensive encephalopathy.
• Visual impairment.
• Diffuse glomerulonephritis of a chronic nature.

To avoid the consequences, you need to be responsible for your health. In the early stages, glomerulonephritis is completely treatable. You can get rid of it in a few weeks, while avoiding complications.

Diagnostics

First of all, the doctor interviews the patient. It is important to find out exactly what disease he recently suffered, because glomerulonephritis has an infectious nature of occurrence.

Then a visual inspection is carried out, and only then the person is sent for analysis. As a result of the study, it is possible to identify such changes:

• The content of red blood cells in the urine. At the initial stage, they are fresh. At later - leaching.
• Albuminuria (moderate, 3-6%).
• Hyaline or granular cylinders in urinary sediment.
• Deterioration of renal filtration function. It is determined by studying the clearance of endogenous creatinine.
• Decreased urine output and nocturia. Identified through a test of Zimnitsky.

Also, patients have leukocytosis and an increased erythrocyte sedimentation rate. This is revealed through the study of blood donated for general analysis. A biochemical study confirms the presence of creatinine, cholesterol and residual nitrogen.

By the way, patients are also often referred for ultrasound of the renal vessels and ultrasound. A biopsy is indicated only in especially severe cases, when the above diagnostic methods do not give accurate results.

Drug therapy

Now you can talk about what drugs should be taken to eliminate the symptoms and treatment of glomerulonephritis in adults.

As a rule, doctors prescribe these medicines:

• Wobenzym. Immunomodulating and anti-inflammatory agent, the basis of which are enzymes (protein molecules) of animal and vegetable origin. The use of this drug is aimed at reducing the number of immune complexes in the body, normalizing the permeability of the vascular walls and regulating the adhesion of blood cells.
• "Kanefron N". This is a herbal preparation, a diuretic of plant origin. He has several actions at once - antimicrobial, diuretic, anti-inflammatory and antispasmodic.
• Metipred. Glucocorticosteroid of synthetic origin, which has an immunosuppressive, anti-allergic and anti-inflammatory effect. Also, the drug reduces the amount of globulins in plasma, increases the synthesis of albumin in the kidneys and liver, normalizes carbohydrate metabolism, increases the resistance of the cell membrane to the action of various damaging factors.

Of course, this is not the entire list of drugs indicated for use. However, it should be noted that only a nephrologist who is involved in the treatment of glomerulonephritis can prescribe therapy.

The clinical recommendations of the doctor are based on the results of diagnosis, and therefore are not in doubt. But self-medication and the decision to independently prescribe yourself taking any drugs can be fraught with complications and other health problems.

Nutrition Principles and Prohibitions

Talking about the symptoms of glomerulonephritis in adults and the treatment of this disease, it is necessary to talk about what diet you need to follow a person who has encountered this ailment.

In the acute form, nutrition should ensure the unloading of protein metabolism. It is necessary to draw up a diet so that the outflow of urinary fluid is maximized, and blood circulation and other metabolic processes are accelerated.

It will be necessary to reduce the energy value of the daily menu to 2,200 kilocalories and reduce the amount of foods containing carbohydrates and fats. Food should contain as many minerals and vitamins as possible. But the volume of fluid drunk per day will have to be significantly reduced.

Also, observing the diet for glomerulonephritis, you need to abandon the following products:

• Salt and all food containing it. Including bread, cheeses, confectionery and flour products, etc.
• Products with artificial components.
• Non-seasonal vegetables (they contain nitrates).
• Decoctions of legumes.
• Rich strong broths.
• Lamb, duck, pork, goose.
• Canned food, smoked meats.
• Sausage.
• Baked and stewed meat that has not been previously boiled.
• Sour cream, fat, animal fats and cream.
• Salted and smoked fish.
• Caviar.
• Canned fish.
• Pickled, salted and pickled vegetables.
• Shop sauces and seasonings.
• All sharp.
• Radishes, onions, legumes, garlic, radish, sorrel, spinach, mushrooms.
• Mineral waters with sodium bicarbonate composition.
• Cocoa, tea and coffee.

In addition to the above, you will have to abandon allergens, which include many berries and citrus fruits.

Allowed Products

Continuing to discuss the principles of the diet shown for glomerulonephritis, it is worth considering the list of those products that can be included in the diet.

So, the menu should be based on the following products:

• Sweet pastries and bread without salt.
• Low-fat meat (turkey, chicken), previously boiled before final cooking. You can also make minced meat. But it also needs to be boiled. Then you can stuff them vegetables, make cabbage rolls, casseroles or pancakes with it.
• Low-fat fish.
• Sauces from vegetables, low-fat sour cream, tomatoes, milk or onions.
• Caraway seeds, parsley, dried dill.
• Soups on vegetable broth or water. You can add cereals, pasta, onions (but after boiling). Borscht, beetroot soup and cabbage soup are allowed.
• Pasta and cereals. From them you can make puddings, meatballs, pilaf, casseroles.
• Yogurt, yogurt, nonfat milk (up to 400 ml per day).
• Eggs, maximum 2 pieces. You can cook them soft-boiled or make omelets.
• Apricots, apples, watermelon, peaches, bananas, nectarines, melon, figs, strawberries.
• Jelly, fruit and berry purees, compotes, jellies, jams.
• Rosehip infusion, freshly squeezed juices, tea with sugar and lemon.
• Marshmallows, popsicles, honey, candy, caramel.

Based on the allowed products, you can create a varied menu. So a person diagnosed with glomerulonephritis should not worry about whether his diet will be full.

Folk remedies

With glomerulonephritis, the clinical recommendations listed above must be followed. And medication, combined with proper nutrition, is usually enough to restore health, but many decide to resort to folk remedies. And therefore, it is worth telling about them in the end.

Here are some simple recipes:

• Parsley seeds (25 g), hop cones (10 g), hawthorn and motherwort (20 g each) mix and pour boiling water (300 ml). For half an hour send to a water bath. Then strain. Drink three times a day for 1 tbsp. l
• Peeled and washed oats (5 tbsp. L.) Pour 1 liter of milk. Boil it until cooked over low heat and take 100 g three times a day.
• The catchment (2 tbsp. L.) Pour boiling water (250 ml) and cook for 5 minutes over high heat. Strain. Drink the resulting volume per day in three divided doses in equal portions.
• Shredded burdock root (4 tbsp. L.) Pour 1 liter of boiling water and send to a small fire. Keep until half the water has evaporated. Then remove the broth, strain, and then add honey (2 tbsp. L.). Drink three times a day for 0.5 cups, and at bedtime - one whole.

In general, any herbs that have antimicrobial and anti-inflammatory properties are suitable for the treatment of glomerulonephritis. Among them are a pharmacy chamomile, plantain, calendula, dogrose, oak bark, St. John's wort, yarrow, sage, birch buds, branches of sea buckthorn.

The main thing is not to get involved in infusions and decoctions. Uncontrolled intake of them can also negatively affect health, as well as drug abuse.