Nephritic syndrome: causes, symptoms and treatment

Jade syndrome is a dangerous inflammatory process in which the glomeruli of the kidneys are involved. This pathology is characterized by an increase in the level of nitrogen in the blood. It is worth noting that many confuse nephritic and nephrotic syndrome. These are two completely different kidney diseases, which differ from each other in pathogenesis and clinical manifestations. In the first case, we are talking about inflammation of the organ, and in the second - about damage to the kidney tissues. However, there is no fundamental difference between the two. Nephritic syndrome and nephrotic syndrome are related diseases, manifested by various symptomatic complexes against the background of lesions of the excretory system.

Types of disease

Nephritic syndrome is divided by the nature of the course into three types:

• subacute - the pathology develops over a long time, in some cases short-term symptoms occur;
• acute - this form suddenly manifests itself with severe pain in the lower back;
• chronic - in this form, relapses are replaced by remissions as a result of exposure to provoking factors.

What causes kidney jade

In most cases, the cause of the disease is streptococcal infection. Acute nephritic syndrome does not appear immediately, but with the active influence of the pathogen on the kidneys, the symptoms develop with lightning speed. It is worth noting another important nuance: this pathological condition never occurs in a person with healthy kidneys. For the occurrence of nephritis, a favorable condition is necessary - any renal dysfunction.

Infection with streptococcus is far from the only factor that can provoke the development of the disease. In addition to the penetration of bacteria, autoimmune diseases, for example, vasculitis, lupus, can become the impetus for the manifestation of the disease. In this case, jade appears against the background of the accumulation of glomerular complement in the basement membrane. A list with other potential causes of the disease is as follows:

• post-streptococcal glomerulonephritis (nephritic syndrome develops against a background of bacterial damage to the deep tissues of the organ);
• meningococcus;
• Pneumococcus;
• typhoid fever;
• endocarditis;
• sepsis;
• viral infections (chickenpox, hepatitis, mumps, rubella, measles, infectious mononucleosis, syphilis, etc.);
• autoimmune disorders.

Possible simultaneous exposure to several of these factors. Moreover, any form of nephritic syndrome can lead to complications and entail adverse consequences.

What are the signs

Diagnosis of nephritic syndrome, as a rule, is not difficult for specialists. The disease is characterized by a number of specific symptoms that, with a low degree of probability, can be confused with other renal pathologies. Meanwhile, special attention is paid to the differential diagnosis of nephritic syndrome from nephrotic.

The patient may experience the first symptoms of nephritis some time after the infection enters the body. The duration of the incubation period depends on the type of pathogen. For example, streptococcus manifests itself 10-15 days after infection.

All signs of jade are divided into classic and general. The first group includes manifestations that occur in every patient with nephritic syndrome:

• The presence of a significant amount of blood in the urine (hematuria). With a severe form of the disease, macrohematuria is possible (urine is dark maroon, acquires a thicker consistency), but this symptom is found in only a third of patients.
• Hypocommentility - focal and segmental necrosis with proliferation of renal glomerular epithelial cells.
• Swelling of the face and lower extremities. The face and neck begin to swell in the morning, and the legs in the afternoon; after awakening, patients have cardiac swelling of the lower abdomen and ankle joints.
• The development of arterial hypertension.
• Acute failure of the left ventricle and atrium, expressed by increased heart rate and pulmonary edema.
• Decreased urine output.

Nonspecific symptoms

They are characteristic of many diseases. Most often, it is these symptoms that occur first. These include:

• prolonged lack of appetite and, as a consequence, weight loss;
• persistent headaches;
• fluid retention in the body and swelling of the body;
• persistent increase in body temperature, 37-38 °;
• sharp pain during palpation and light pressure on the lumbar region and abdomen;
• weakness, malaise;
• nausea, vomiting.

The most severe consequence of nephritic syndrome in children is its smooth transition into a chronic form. The constant nature of the course of the disease can be very dangerous. Chronic nephritic syndrome is latent, and therefore it is possible to recognize relapses and start timely treatment only in isolated cases.

Is there a difference between jade and nephrosis

As already noted, nephritic and nephrotic syndromes are various complexes of clinical signs that manifest themselves in the development of renal pathology. These two conditions have similar features and arise against the background of existing disorders or infectious lesions. Since both pathological processes have a common localization, the symptoms are almost the same for the nephritic and nephrotic syndrome. Differences will be in the results of analyzes and other signs of damage to the excretory system. As for the general symptoms, the course of the nephrotic syndrome is accompanied by swelling, general weakness, back pain and pallor of the integument.

The main differences

Nephrotic and nephritic syndromes are essentially consequences of other kidney diseases. Both pathological conditions have a number of common features, however, due to the difference in course, specialists manage to differentiate them from each other, make the correct diagnosis and prescribe the correct treatment.

The difference in laboratory results is the main difference between nephritic and nephrotic syndrome. Visually, you can familiarize yourself with the features of each of the pathologies in the table below.

Diagnostics

To confirm the diagnosis, the patient is prescribed urine and blood tests, the results of which determine the parameters of oliguria, proteinuria, the number of red blood cells and white blood cells, a change in the titer of AT, and a decrease in the hemolytic activity of some complements.

Without fail, the patient is sent for ultrasound screening and X-ray examination - instrumental diagnostics will provide accurate data on the size of the kidneys and the speed of the filtration processes in the glomeruli.

Basic principles and approaches to treatment

Clinical recommendations for nephritic syndrome come down to one thing - the fight against the root cause. The attending physician draws up a strict diet for the patient, implying a ban on salt and limited intake of protein products. The daily volume of fluid is also subject to reduction. Without exception, spices, acid drinks, black tea, coffee, fried and canned foods are excluded from the diet.

In the treatment of nephritic syndrome, it is very important to ensure sufficient intake of vitamins and valuable trace elements. Semi-prepared foods and fast food should be discarded. In case of nephritic syndrome, carrots and lettuce containing vitamin A, nuts, beets and apples, in which vitamin B is present, should be included in the diet. Ascorbic acid, which is rich in citrus fruits, cabbage, bell pepper and rosehip, will help strengthen immunity. Vitamin E is found in beans and vegetable oils.

Unlike nephritic syndrome, nephrotic syndrome is manifested by a more pronounced retention of fluid and salts in the body. However, specialists prescribe drugs to restore water-salt metabolism and diuretics in both cases. If nephritis or nephrosis goes into the acute stage, complicated by the development of renal failure, the patient is shown dialysis and appropriate resuscitation measures. Treatment is carried out under the constant supervision of medical staff.

Drug therapy

For symptomatic therapy of nephritic syndrome, the patient is prescribed drugs of the following groups:

• Diuretics.
• Calcium-containing products.
• Antiallergic.
• Vitamin-mineral complex (ascorbic acid, rutin).
• Antibiotics (in the presence of an infectious focus in the body).
• Antihypertensive and cardiac drugs.

With nephritic syndrome, diuretics such as:

• Thiazides. Hypothiazide (an analogue of Dichlothiazide) is prescribed in a dosage of 1 to 4 tablets per day.
• Furosemide and ethacrylic acid. The drug "Lasix" for the treatment of symptoms of nephritic syndrome is taken orally or injection at a dose of not more than 200 mg per day. Orally, the drug is taken on an empty stomach, the entire dose is administered simultaneously and with intravenous infusion. "Uregit" (the main active ingredient is ethacrylic acid). The principle of action is similar to the previous drug, which is based on the active substance furosemide. "Uregit" is prescribed after a meal, starting with 50 mg per day (1 tablet). Gradually, the dosage is increased to a maximum of 200 mg.
• Potassium-sparing diuretics. This group includes drugs “Aldactone” and “Veroshpiron” - effective aldosterone antagonists. Such drugs are also prescribed for the treatment of nephritic syndrome, which is not accompanied by hyperkalemia.

In case of arterial hypertension, Anaprilin is prescribed for treatment. However, this drug is not suitable for bradycardia. Typically, a drug of 60-160 mg / day is prescribed. For patients with heart failure with nephritic syndrome, glycosides are required. Before prescribing the patient to take drugs of this group, the level of potassium in the blood plasma is definitely determined, since with low rates (less than 3.5 mmol / l) such drugs are contraindicated. During periods of remission of the disease, stay in a resort area with a dry climate will benefit.

Possible complications

With the unexplained pathogenesis of nephritic syndrome, it is not easy to overcome the disease. Due to the long course of the disease, kidney cells begin to die. The organ decreases in size and gradually loses its functionality. If the kidneys cannot be restored, the patient is transferred to hemodialysis. The decision to artificially maintain the excretory system means only one thing - the patient needs an urgent organ transplant. A kidney transplant is an expensive surgical procedure that also requires a long rehabilitation period.

In parallel with the pathological process in the kidneys, the work of the cardiovascular system is disrupted, as a result of poor-quality blood purification. Arteries become thinner, slow necrotic changes are observed in myocardial cells. In this case, a fatal outcome with nephritic syndrome is an extremely rare phenomenon. Most often, death occurs in elderly patients suffering from heart failure.

Forecast

Thanks to the timely differential diagnosis of nephrotic syndrome, patients are more likely to recover without complications. In general, the prognosis for patients is favorable. It is important to seek the help of specialists at the first symptoms of the disease - proper therapy will help normalize kidney function within a couple of months. The course of the disease largely depends on the stage of the disease, the patient's age and the presence of chronic diseases that can aggravate the clinical picture.

In most cases, the elimination of the inflammatory process automatically entails the stabilization of blood pressure, however, this only happens if the cause of hypertension was precisely kidney problems, and not some other disease accompanied by the same symptom.

With the course of nephritic syndrome, associated with serious complications (uremic coma, acute heart failure, cerebrovascular accident, etc.), the prognosis is unfavorable. Among the most common consequences, it is worth noting a severe form of anemia and recurring hypertensive crises.

Alternative treatment

Kidney diseases have long been treated with herbs. Despite modern technologies and achievements of the medical industry, many people suffer from diseases of the excretory system today. Moreover, traditional treatment is not always effective and safe enough - many drugs have a wide range of contraindications and side effects.

Properly selected funds, which are prepared at home according to the recipes of traditional healers, really help to alleviate the condition of the patient. For folk treatment, various decoctions and infusions of herbs are used. Specialists often prescribe alternative methods to patients at the same time as medications for nephritic syndrome. According to the recommendations of doctors, the most effective can be called funds prepared according to the following recipes:

• Rosehip infusion. The drink is prepared as follows: two tablespoons of dried fruit pour 500 ml of boiling water. Then the product is left for 1 hour to insist. A filtered and cooled drink is taken during the day every two hours for several sips.
• Infusion of birch leaves. Raw materials are poured with hot water in a ratio of 1: 2. It will take several hours to insist the leaves, so it is best to prepare the infusion in the evening and leave until the morning, covering it with a lid. The drug is taken half a glass three times a day after meals.
• Infusion of the flowers of calendula, knotweed, bark, water lily, St. John's wort, chamomile, chicory flowers, immortelle. All components are used in equal amounts (1 tbsp. L.), Mixed and poured 1 l of hot boiled water. Drink infusion before breakfast and dinner 100 ml.
• Infusion of horsetail field and bear ears. Dry birch leaves are sometimes added to herbs. Prepare the tool in the same way as the previous one. For infusion, the drink needs at least half an hour. You will have to drink the medicine daily for half a glass on an empty stomach.

Prevention

Often the attending physician with a mild degree of nephritic syndrome recommends the use of folk remedies for prevention. However, in this case, decoctions and infusions are prepared in a lower concentration of active ingredients. The use of medicinal herbal drinks implies compliance with the dosage corresponding to the age, weight and other individual characteristics of the patient. In addition, you can not discount the likelihood of an allergic reaction and intolerance to certain substances.

In general, the prevention of nephritic syndrome is the prevention of root causes of pathologies. If viral and bacterial infections are affected, cardiac abnormalities are possible, which negatively affect the functionality of the kidneys.

It is important to follow all the instructions and recommendations of doctors strictly. You can not interrupt the treatment of kidney disease. Even those patients who have achieved full recovery have to take drugs for a long time and observe a special regimen.

Remember that the kidneys are a kind of filter that helps our body get rid of toxins and harmful substances. Treat your health with care and do not self-medicate!