In the diagnosis of glomerulonephritis an important role is played by the correct and timely diagnosis. Which should include both general clinical examination methods and additional ones. It is they that will allow for differential diagnosis between the acute and chronic process, will allow to determine the form of glomerulonephritis (nephritic, nephrotic), which is very important in the further tactics of treatment of the patient. Primary and secondary prevention of glomerulonephritis (post-streptococcal and other types) includes a set of measures aimed at maintaining health.
Causes
In most cases, the cause of glomerulonephritis is a severe infection that causes kidney damage. These infections include:
- angina;
- chickenpox;
- sepsis;
- scarlet fever;
- Hepatitis B;
- infectious monoculosis.
And some other infectious diseases. In addition, the factors causing glomerulonephritis include systemic disorders:
- hereditary pulmonary-renal syndrome;
- lupus;
- vasculitis.
In some cases, impaired renal function can be caused by the introduction of vaccines and serums, usually of low quality, or in the presence of severe allergic reactions to drugs.
One of the factors is poisoning the body with toxic substances, including alcohol, nicotine, and mercury. Organic solvents, lead and other compounds. With radiation exposure, glomerulonephritis also often develops.
It should be noted that the disease begins to appear on average after 1-4 weeks from the moment the above negative factors affect the body. Early diagnosis of the disease helps to avoid its development and further complications.
Symptoms
Symptoms of glomerulonephritis begins to manifest itself actively some time after the infection that provoked it. It should be noted that in children the development of glomerulonephritis occurs against a background of more pronounced, acute symptoms, while in adults it proceeds in a mild latent form. In the acute development of this disease, the symptoms have the following characteristic indicators:
- An increase in body temperature, the appearance of chills, loss of appetite, a general deterioration in well-being;
- Localization of pain in the lumbar region, headaches;
- Violation of urination (and in the initial stage, the amount of urine is reduced, and as the disease develops, the amount of urination increases), the presence of blood impurities (hematuria) can be detected in the urine itself;
- Severe morning swelling, which gradually passes throughout the day;
- High blood pressure (hypertension).
Depending on the form in which glomerulonephritis proceeds, specific symptoms are most pronounced. For example, in the nephrotic variant, urinary symptoms prevail, in the hypertensive variant, on the contrary, urinary symptoms are weak, and hypertensive symptoms predominate, in the latent variant, all symptoms are very weak.
Diagnostics
General examination methods:
- clinical blood test
- Clinical analysis of urine (required!);
- urine analysis for daily proteinuria (determination of daily protein in urine);
- urine analysis according to Nechiporenko;
- urine analysis according to Zimnitsky (assessment of the concentration function of the kidneys);
- blood biochemistry (cholesterol, total protein and its fractions, urea, creatinine, electrolytes - K, Na, Cl);
- smear from the throat on the microflora (allocation of streptococcus group A - with suspected nephritic form of glomerulonephritis).
Monitoring:
- blood pressure control;
- daily urine control;
- additional diagnostic methods;
- immunological blood test (titer - antistreptolysin O, CEC);
- assessment of renal function (glomerular filtration rate according to Schwartz);
- Ultrasound of the kidneys with an assessment of renal blood flow ECHO-ECG.
Specialist consultation:
- ophthalmologist (fundus examination);
- otolaryngologist (rehabilitation of chronic foci of infection);
- kidney biopsy (in case of chronic steroid-resistant glomerulonephritis, to assess the morphological state of the kidneys).
Treatment
There are several ways to treat the disease “acute glomerulonephritis” medically, all of them depend on where the disease originally came from. If it began to develop due to the fact that a streptococcal infection was introduced, then the specialist prescribes treatment with a drug such as Penicillin. This is one of the only drugs that does not adversely affect the kidneys.
The drug is used intramuscularly, with an interval of once every four hours, the required volume is 500 LLC ED. The course of treatment in this way should be at least ten and no more than fourteen days. If for some reason you do not want to take Penicillin, you can inject Oxacillin instead, the dosage is exactly the same.
In some cases, pathogenetic therapy is carried out, it is based on the use of anti-inflammatory and suppressing the negative activity of various drugs. Such agents belong to the group of cytostatics and glucocorticoids. The second is used if a person has kidney or heart failure, as well as with arterial hypertension.
Among these medicines is Prednisolone. The daily dose of such a drug is no more than two milligrams. If this drug does not give positive results, then the doctor prescribes cytostatics, and they can also be prescribed if the first medicine causes negative reactions.
The most common medication is Cyclosporin, its daily dose depends on the weight of the person and is calculated as follows: not less than 2.5 and not more than 3.5 milligrams per kilogram of weight. Treatment with this drug should occur under full supervision, which is carried out by giving blood for analysis.
To improve blood circulation in the kidneys and stop the development of thrombosis, doctors prescribe antigreagent and anticoagulant drugs. These include the following:
- Heparin
- "Dipyridamole" and others.
The first is prescribed at the rate of not more than 30 IU per day, and the second from 400 to 600 milligrams also per day. The course of treatment with these drugs should not exceed two and a half months.
Other means
In addition, the following medicines can be used to get rid of acute glomerulonephritis:
- Drugs that lower a person’s blood pressure include Enalapril as an example. Its daily dose is from 10 to 20 milligrams. Ramipril may also be appointed. His daily norm is no more than 10 milligrams and at least two and a half.
- Medicines with which excess fluid is removed from the human body. These include Aldacton, its daily rate should not exceed 300 milligrams. You can use "Furosemide", its daily norm is from forty to eighty milligrams.
- The following medications that help get rid of heart failure are Hypotypzide and Uregit. Their daily rate ranges from fifty to one hundred milligrams.
The principles of treatment and prevention of glomerulonephritis (acute and chronic forms) are closely interrelated. All events are held in the complex.
Alternative treatment
Treatment of glomerulonephritis with alternative methods of treatment is possible only at the initial stages, when the signs of the disease are well manifested. It is best to resort to this type of treatment only after prior consultation with a specialist. Here is a recipe for an effective folk medicine, this will require:
- three tablespoons of dried birch leaves;
- four tablespoons of flaxseed;
- three tablespoons of dried steel root.
Pour the resulting mixture with boiling water and leave to infuse. You need to drink the resulting drink three times a day, drinking less than half a glass, but not more than one week. After it, swelling subsides and heart pain disappears. Also, the medicine is a good tool that lowers blood pressure.
Diet
It is recommended to adhere to a diet, excluding the following foods from the diet:
- apricots
- sweet apples;
- cottage cheese;
- potatoes.
It is good to eat a pumpkin, daily for a whole day, in small portions. In general, such a disease entails a hospital regimen and the need to eat on a particular diet.
With the help of alternative methods, you can only relieve severe pain caused by the disease, and is also suitable as preventive methods. The main thing is to identify the disease in its initial stages, otherwise in the future it will give a complication and begin to negatively affect the whole body.
Primary prevention
The primary prevention of chronic glomerulonephritis is primarily aimed at the general strengthening of the body's immune system and the prevention of factors and diseases that may lead to the development of kidney diseases. The primary preventive measures include the following:
1. Timely diagnosis and treatment of infections in various organs that can provoke impaired renal function.
2. Regular monitoring and monitoring of the stage of glomerulonephritis (tests, visits to the attending physician).
3. Since one of the most important factors in the fight against infectious diseases is the person’s own immunity, the primary prevention of glomerulonephritis in children should naturally be aimed at strengthening it, namely:
- walks in the fresh air, physical education;
- balanced diet, rich in vitamins and minerals;
- feasible hardening (the use of a contrast shower, dousing with a gradual decrease in temperature, walking barefoot, regular walks in the winter).
4. Drug therapy aimed at preventing relapse (prescribed and controlled by the attending physician).
Secondary prevention
To prevent the chronic form of glomerulonephritis, it is necessary to adhere to certain preventive measures that will help prevent the worsening of the symptoms of the disease.
In contrast to the primary preventive measures for glomerulonephritis, which are, first of all, aimed at preventing infection of the body, increasing immunity, a medical solution to the resulting pathologies. Secondary prevention is the optimization of lifestyle, the normalization of life.
What does this type of prevention include?
Secondary events include the following:
- Optimization of physical and psycho-emotional stress, including limitation by sports, avoidance of stressful situations.
- Restrictions related to working conditions, which include compliance with sanitary standards at the workplace (it is not recommended to work in a damp room, to lift weights, it is forbidden to use toxic chemicals and other harmful substances) In addition, night shifts and lengthy business trips should be limited.
- An important element of prevention is the diet - with glomerulonephritis, it is built on reducing the use of protein products, which can be an extra burden on the kidneys.
- Regular medical examination at the attending physician.
Prevention of acute glomerulonephritis
The main rule for the prevention of this disease is to try to avoid various infections. Some recommendations:
- If you find signs of even the most harmless infections, you should immediately make an appointment with a doctor to take treatment recommendations from him.
- Any infectious disease is characterized by high fever, worsening condition, chills and intoxication of the body.
- It is strictly forbidden to independently choose drugs for treatment, they can only be prescribed by a qualified specialist.
- If you start treatment on time, the treatment process will go pretty quickly and there will be no side effects.
- Try to limit yourself from any hypothermia, and for those patients who have been diagnosed with allergic reactions of any genesis, any vaccinations are strictly prohibited.
- In order to prevent recurrence of the disease, you need to go to an appointment with a nephrologist annually. A fatal outcome is practically excluded with such a disease, but still there is a chance, it is better not to risk it.
- People who have had such an illness should avoid working in humid and cold rooms.
- If the patient had seizures, then he must adhere to a certain diet. It is necessary to refuse salty, fatty or too spicy food.
Prevention of chronic glomerulonephritis
When the disease has become chronic, there are a number of measures that can prevent a new outbreak of the disease. For the prevention of glomerulonephritis, the following rules exist:
- special daily routine with good rest and a balanced diet with limited salt and liquid, sodium-free diet;
- Fear of overstrain, both physical and nervous; excessive loads that can provoke the disease should also be avoided;
- do not undergo hypothermia;
- Do not be in a damp room or close to harmful chemicals;
- be registered at least 3 years.
Measures for the prevention of chronic glomerulonephritis are to eliminate all the factors that may cause the disease.
The role of the immune system
In this case, it is necessary to pay attention primarily to the immune system in order to strengthen the defenses. The body must be able to cope with viral infection and other pathologies. To do this, you must:
- treat infectious diseases on time, and complete the course of therapy, otherwise pathologies will affect the work of the kidneys;
- follow the doctor’s recommendations when taking medications that have been prescribed in connection with any disease;
- take urine and blood several times a year for testing;
- pay attention to the proper diet, excluding fried, smoked and too salty foods from the regular menu, but eat more fruits and vegetables;
- take walks every day, do physical exercises;
- do hardening.
Also, the patient has the right to have special working conditions without night shifts and hypothermia.