Nephritis performance and the special treatment

Nephritis special performance: a clear majority of patients infected with Streptococcus history Individual patient history lighter upper respiratory infection without any symptoms, but Antistreptolysin - "O" titer increased. Nephritis and the severity of the prodromal symptoms of infection not directly proportional. Streptococcus infection in the general after 7-20 days nephritis clinical manifestation, this primary performance most have disappeared, some patients incubation period can be shorter, about 1 / 5 of cases for 4-7 days, the most elderly three weeks, more than three weeks are extremely rare.
① typical gross hematuria: often the first symptoms of patients, or about 40 percent. Urine uniform or the brown muddy water samples were washed meat, gross hematuria sustained a few days to several weeks after the disappearance. Hematuria can be serious when combined with dysuria, urethral discomfort, but no frequency, urgency,such as urinary tract symptoms stimulation, this feature is different from urinary tract infection.
② special facial edema: is the disease after the first signs, accounting for 80 1 90%. Good morning wake up two eyelid edema is the often-mentioned "nephritis face" serious systemic edema, a finger pressing no obvious when the Depression. Most patients edema in 2-4 weeks after its own dissipated; small number of patients (about 20 percent) edema evident and sustainable few months, expressed as nephrotic syndrome. If edema or not dissipated long nephrotic syndrome, suggesting that poor prognosis. Edema is the main reason for decline in glomerular filtration rate, tubular resorption increased systemic vascular lesions caused increased vascular permeability, and hypoproteinemia, and so on.
③ obvious hypertension: about 80 percent. More moderate blood pressure increased (17.3-20/12-14.6 kPa), a small number of patients can experience serious high blood pressure, diastolic blood pressure but rarely more than 16 kPa. Hypertension is the main reason for water and sodium (salt) in the body retention, increased blood volume. Nearly hypertension and edema in parallel, can reduce the edema and decreased gradually. If sustained increased blood pressure, medication is not significantly declined, the illness often heavier. Elevated blood pressure can be sustained increase renal damage. Patients frequently manifests itself headache, dizziness. Severe high blood pressure, patients can suddenly appeared ventilation, coma. Medically referred to as "hypertensive encephalopathy," we must actively treatment.
④ urine volume reduction of most of the patients, patients in the early stage of daily urine output of less than 500 milliliters. As voiding reduction in the accumulation of toxic substances, blood urea nitrogen, creatinine, and so increased the renal function decline began, and nausea, vomiting, diarrhea, dizziness and other symptoms. Two weeks after the general gradual increase urine output, renal function gradually returned to normal. However, a small number of patients (about 5%) from oliguria developed to anuria, general edema increased blood pressure continues to increase, there will be many symptoms of uremia, such as flustered, chest tightness, difficulty breathing, not supine, cough hemorrhage sputum samples of the foam, which is nephritis patients with heart failure, if not promptly where rapid heart can stop beating. Patients also often flu fatigue, anorexia, nausea, vomiting, diarrhea, drowsiness, blurred vision, and so on.
⑤ almost all patients with acute nephritis have protein in urine, and the majority of protein in the middle of the above, some patients may have severe proteinuria. If the illness to the development of advanced uremia, but reduce urinary protein. Routine urine test, we can see that more red blood cells, leukocytes bit, but also can have hemoglobin, or red blood cells of the type of pipe, which is an important feature of acute nephritis. Urine also can see a small number of particles of the type and some tubular epithelial cells and leukocytes tube. Late in the urine of patients that wax-like tube and transparent tube. More red blood cells in urine protein and disappear slowly, can exist for a long time, going on for several months, and some can be for several years, until the chronic phase can hardly dissipated.
⑥ most acute nephritis patients often a transient elevated serum creatinine and urea nitrogen. Through active treatment, most patients can return to normal. Elderly patients have renal function has been weakened, even if aggressive treatment, it is difficult to restore. Such patients poor prognosis. Often chronic nephritis hypertension, anemia, urinary the emergence of various tube type, blood urea nitrogen, creatinine is elevated, and the illness was repeatedly increased, long-term, can be gradually developed into uremia.
All in acute streptococcal infection after 1-3 weeks in hematuria, proteinuria, oliguria, edema, hypertension, and other symptoms. They should think of acute nephritis. But some patients symptoms significantly, after continuous inspection of a number of urine, but also able to make the diagnosis. If normal urine examination, clinical diagnosis more difficult, to do a clear diagnosis of kidney puncture. Acute exacerbation of chronic nephritis period much like the clinical manifestations of acute nephritis; urine in the emergence of various tube, in particular generous type of renal failure, also known as the cereus;decreased anemia; difficult long-term high blood pressure decreased renal ultrasonography see kidney volume reduced if patients by late appetite, nausea, vomiting, diarrhea and other symptoms, it is necessary to check whether or not to the hospital suffering from chronic nephritis.
There is no magic way of nephritis is essentially symptomatic treatment, including rest, preventing excessive, appropriate restrictions protein food, diuretic to reduce edema, lower high blood pressure, the prevention of treatment of heart failure, hypertension and other fatal complications encephalopathy .
Acute need bed rest until the gross hematuria disappeared, edema, blood pressure returned to normal, serum creatinine, blood urea nitrogen to normal after all, can gradually get out of bed activities.
Diet should be rich in a variety of vitamins, daily consumption of protein should be maintained at 40-70 grams. When too little protein intake on kidney adverse repair, if excessive protein intake would increase the burden on the kidney, renal dysfunction, urea and creatinine fluoride are increased. According to elevated blood pressure and edema decide the extent of salt in the diet. Where edema obviously, significantly increased blood pressure, salt intake should be limited, while reducing the amount of drinking water if slight edema, blood pressure is not high, not too many restrictions. If there is a significant renal insufficiency, should be limited quantity of protein income, particularly vegetable protein, such as soybean, peanut, etc., should be restricted. Proper eating fish, eggs,like animal protein, which kidney useful, but it should be limited.
Take care not to damage the kidneys of drug use, such as streptomycin and gentamicin, such as sulfa drugs should be given to effective diuretic, antihypertensive drugs can be used, if necessary, hormone therapy and other drugs. Proper application of nutritional protection kidney drugs, such as inosine, ATP, cytochrome C, and so on. Diuresis, reducing high blood pressure, preventing heart and brain complications, treatment is the focus. Patients of nephritis, a serious kidney edema syndrome, in addition to using hormones, can also be applied, such as immunosuppressive agents cyclophosphamide, but should be under the guidance of a doctor medication. Chinese medicines are very effective on nephritis, and many prescriptions as Liuweidihuang pill can be taken in accordance with long-term illness.