Inflammation of the kidneys, which is characterized by damage to the filter apparatus, is commonly called "glomerulonephritis" in medicine. The classification of pathology depends on the sources of the onset of the disease, the specifics of the course. In most cases, with this disease, glomeruli of the kidneys (glomeruli) are damaged. However, the pathological process may also cover other areas of the kidneys: tubules, intercellular tissues. Most often, the disease is diagnosed in children under 12 years of age. However, one cannot exclude the risk of developing an ailment in adulthood.
Disease characteristics
What is glomerulonephritis? This is a number of different ailments, which are characterized by inflammatory damage to the kidneys. Most often, they are provoked by the negative impact of infections or allergens that have entered the body.
Pathology is manifested by the defeat of glomeruli, renal tubules, and also vessels. To present in more detail what constitutes a disease, one should touch on anatomy. Renal glomeruli perform one of the most important functions in the body. They filter and remove toxins, excess fluid, decay products and other unnecessary substances.
Glomeruli are localized in the body of the kidney. They are a cluster of capillaries of a loop-like form. In a normally functioning body, blood moves along the arteriole. Then it penetrates the renal glomerulus. This is where filtration occurs and urine forms. All waste, unnecessary substances are screened out in the urinary tubule. From it they enter the kidney cavity, and then into the bladder. Blood, purified from undesirable impurities, leaves the glomerulus through the efferent arteriole.
A slightly different picture is observed if a person develops glomerulonephritis. This is a pathology characterized by an increase in patency of the renal filter. As a result, the necessary function is not fully implemented. Large structures can enter the urine: protein, red blood cells, white blood cells. And these components are vital to the body. The progression of the disease leads to a deterioration in blood purification. Excess fluid and harmful substances are not excreted from the body.
Most often, the basis of the disease is the body's response to a variety of infections or allergens. But sometimes the pathology is autoimmune. In this case, the disease develops against the background of damage to the kidneys with their own antibodies.
Causes of the disease
Why can glomerulonephritis occur? Classification to some extent depends on the cause of the disease.
The main sources of glomerulonephritis are the following factors:
- Streptococcal infection. This is the most common ailment catalyst. Most often, kidney damage is provoked by improper therapy of streptococcal tonsillitis. In order to cure such a pathology, it is necessary to undergo the full course of antibiotic therapy prescribed by a doctor. It is impossible to kill streptococcus by other methods. And if the infection is not completely eliminated, then after 10-14 days, acute post-streptococcal glomerulonephritis may develop. With this pathology, the body itself begins to attack kidney cells.
- Viral infection. It can also provoke a relapse of the disease.
- Cold. An ailment complicated by kidney inflammation.
- Systemic pathology of connective tissue. The development of glomerulonephritis may be based on rheumatoid arthritis, systemic lupus erythematosus, periarthritis nodosa, and vasculitis.
- Chronic bacterial or viral infections. Pathology can develop against the background of viral hepatitis B, C, syphilis, infectious endocarditis, malaria.
- Metabolic diseases. Amyloidosis, diabetes mellitus, urate nephropathy, gout can lead to glomerulonephritis.
- Blood disease. Lymphogranulomatosis, myeloma, chronic leukemia can play a role in the development of the disease.
- Toxic factors. Abuse of narcotic substances, drugs, alcohol can become triggers for the development of glomerulonephritis; exposure to the body of mercury, lead, solvents, certain types of poisons (for example, bee, snake). The onset of the disease may be radiation sickness, severe hypothermia, vaccination.
Symptoms of the disease
Sometimes pathology can be asymptomatic. Doctors say that in almost half of patients diagnosed with glomerulonephritis, the disease is detected only by medical examination. And the patients themselves do not even suspect the development of such a serious infectious disease in the body.
If glomerulonephritis makes itself felt, then the symptoms will be as follows:
- Swelling. It manifests itself on the face, eyelids. Edema can occur on the lower and upper extremities. The mass of an adult as a result of such symptoms sometimes increases by 7 kg over 7 days.
- Oliguria. There is a decrease or complete absence of urine in the patient.
- Dyspnea. Such symptoms in severe course can lead to pulmonary edema.
- Hematuria Urine takes on a reddish hue. This is dictated by the presence of blood in it.
- Arterial hypertension. The patient is tormented by a persistent increase in pressure.
- The presence of protein in the urine. This is triggered by increased throughput of the renal glomeruli during blood filtration.
- Fever.
- Pain in the lumbar region is bilateral.
- Constant feeling of thirst.
- Vomiting, nausea. Lack of appetite.
And now we will consider what types of pathology such as glomerulonephritis exist.
Disease classification
Pathology is divided according to various signs. That is why there are several of its classifications.
So, let us recall the reasons why glomerulonephritis occurs. The classification of the disease by the sources of appearance will be as follows:
- Primary glomerulonephritis. The kidneys are affected by pathogenic factors.
- Secondary. The disease develops against the background of existing pathologies in the body.
By the nature of the course of the disease can be:
- acute - recent;
- subacute - the pathology lasts a couple of weeks or several months;
- chronic - the disease dragged on for a year, and sometimes a longer period.
According to the degree of distribution, there are:
- a diffuse process that covers the entire filtration system;
- focal lesion.
Forms of the disease
Given the nature of the symptoms, doctors classify the disease as follows:
- Latent form. Pathology proceeds secretly. The patient has episodic erased symptoms. Most often, this form is characteristic of the subacute species.
- Cyclical. It is characterized by acute inflammation. The patient has severe symptoms. As a rule, a rapid recovery occurs. However, this form often recurs.
Varieties of pathology
One of the main characteristics of the disease is the clinical form. Clarification of the disease is carried out taking into account the prevailing symptoms.
Based on the characteristic features, the following types of glomerulonephritis are distinguished:
- Nephrotic. Manifested by swelling.
- Hematuric. The inflammatory process is combined with the symptoms of changes in the urine. There is proteinuria, hematuria in moderation.
- Hypertensive. Dangerous form. It is characterized by persistent increase in pressure. Complications caused by hypertension may form.
- Mixed. With this form, nephrotic-hypertonic signs are combined. Pathology has a rather poor prognosis.
There is another classification - according to morphological symptoms:
- Focal segmental inflammatory process of glomeruli. Pathology is characterized by rapid sclerosis of the renal capillaries.
- Mesangioproliferative nephritis. The most common type of ailment. Pathology is characterized by deposits of immunological complexes to specific pathogens from antibodies.
- Membranous nephropathy. Thickened capillary walls of glomeruli contain expressed protein plaques.
- Mesangiocapillary glomerulonephritis. The glomerular working tissues undergo diffuse sclerotherapy. As a result, they are replaced by connective cells. Pathology is characterized by an unfavorable scenario.
Let us consider in more detail some varieties.
Sharp look
This pathology begins suddenly and has most often expressed symptoms. Acute diffuse glomerulonephritis is characterized by fever, hypostenuria, polturia and hematuria, the presence of lower back pain. The pathology may be bacterial, drug, immune or viral.
Subacute form
Pathology has another name - malignant glomerulonephritis. It is characterized by rapid development. The patient has the same symptoms as in the acute type.
However, all signs of the disease are more pronounced:
- swelling;
- decrease in the amount of urine;
- headache;
- pallor;
- dyspnea;
- discoloration of urine;
- weakness;
- palpitations
- increase in pressure.
The disease is diagnosed on the basis of a blood test, urine.
Membranous Glomerulopathy
This form is characterized by diffuse thickening of the membranes of the glomerular capillaries. Most often, the pathology is associated with an infection. Men are more prone to this type of ailment. In them, membranous glomerulonephritis is characterized by a slow onset. In addition, the disease is accompanied by nephrotic syndrome and proteinuria.
Pathology can be complicated by chronic renal failure, venous thrombosis, which can result in peripheral thromboembolism.
Disease treatment
To combat the disease, complex therapy is undertaken, combining:
- drug treatment;
- adherence to a strict diet (table No. 7a);
- bed rest (with relapse or acute course).
In most cases, such methods can quickly stop the acute course of the disease. In a subsequent patient, rehabilitation therapy is selected.
But sometimes the disease is characterized by a severe course. In this case, hemodialysis is prescribed to the patient. This allows you to protect the patient from severe complications of the disease. A special apparatus called an "artificial kidney" performs blood purification from toxic compounds, excess fluid, and electrolytes. It is recommended for those patients who, against the background of bilateral lesions, developed chronic renal failure.
Kidney surgery
Chronic glomerulonephritis can lead to quite unpleasant consequences. One of them is renal failure. And if the “artificial kidney” apparatus is able to help in the initial stages (with a bilateral process) , then with the running process, the question of transplantation is acute. It consists in transplanting to a person an organ received from a donor.
Kidney surgery is performed only after a thorough examination of the patient. It should be noted that transplantation has its contraindications. In addition, difficulties may arise with the selection of a donor kidney.