The treatment of acute glomerulonephritis and prognosis

Treatment of the disease to rest and symptomatic treatment oriented. Acute renal failure patients should be dialysis, Wait for natural recovery. Inappropriate application of hormones and cell poison. 1, acute bed rest period should normally takes two to three weeks, to be gross hematuria disappeared, restoring blood pressure, edema can be decreased gradually increase the amount of indoor activities. Leftover mild proteinuria and hematuria should be observed without the need to strengthen the follow-up period extended bed rest, if required weight gain urine change again bedridden. Three months advised to avoid intense physical activity. Bed rest can be stopped after gradually increase activity levels. 2, diet and the amount of sodium further prevent water retention, resulting in excessive load cycle with serious-to reduce the burden of kidney, acute phase to limit salt, water, protein intake (daily 3 g below). To have edema, high blood pressure, salt-free or low-salt diet. Edema and to limit heavy water. There are restrictions on protein intake azotemia. Children in the near future application of quality protein, may be 0.5 g / kg calculation. Attention to provide carbohydrate calories. 3,treatment still on the throat, skin should be sensitive to penicillin or other drug therapy 7 to 10 days. 　　 4, the application of acute nephritis diuretics when major pathophysiological changes, cell drain fluid volume expansion, the application is not only to diuretics diuretic swelling, and help control complications. Where the control of water, salt and still, edema, high blood pressure, should be given diuretics. Thiazide available invalid strong loop diuretics such as furosemide and Lee uric acid. In addition can be lifted vasospasm application of the drugs, such as dopamine, to achieve the diuretic purposes. 5, antihypertensive agents Application positive and solid control of blood pressure for increasing renal blood flow and improve renal function, the prevention of heart and brain complications, have a positive therapeutic effect. Thiazide diuretics used by diuretic to control blood pressure can be the purpose. All the rest, water and salt restriction, diuretic and blood pressure is still high, should be given antihypertensive agents. Common reserpine, the first agent may be 0.25 mg daily 2-3 oral dose. Side effects for plugging nose, fatigue, conjunctival hyperemia of the face, bradycardia, and so on. Repeated massive injection should be avoided or combined with chlorpromazine, can occur because of dual category of Parkinson's symptoms, manifested as pronunciation unclear, involuntary tremor, such as increased muscle tone. Pediatric reserpine may not satisfied with the results and with hydralazine pyridazine, 0.1 mg / kg ~ intramuscular injection or 0.5 mg / kg (kg ? d) oral administration, the main side effects are headache, accelerated heart rate, gastrointestinal stimulation. Blood pressure increased significantly, the need to rapidly in recent years, also commonly used blood pressure, calcium channel blockers such as nifedipine, oral or Sublingual eyes, 20 minutes after the blood pressure started to decline, 1 to 2 hours role of the peak and sustained 6-8 hours, or angiotensin-transferase inhibitors, such as captopril acid. In hypertensive encephalopathy may need emergency relief following intravenous drug use: SNP, with pulmonary edema,the role of drug rapid infusion after a few 10 seconds that is effective. But maintaining short time. Suspended after 3 to 5 minutes of disappeared, to remain calm, children can be for five to 20 mg, dissolved in 100 ml of glucose solution, to 1 μ g (kg ? min) speed, as a few drops of blood pressure adjustment. Some should pay attention to speed, to the preparation of fresh, black and transfusion bottle should be wrapped. 6, the acute phase of treatment complications . In addition to the application, if necessary, diuretics plus phentolamine or sodium nitroprusside to reduce the load before and after the heart, not by the control of the treatment of peritoneal dialysis were feasible, and when the rapidly alleviate the excessive load cycle. (2) the treatment of hypertensive encephalopathy: divided by the strong and effective antihypertensive drug control blood pressure, we must pay attention to symptomatic treatment. The seizure can be sustained stability and 0.3 mg application / (kg), the total does not exceed 20 mg intravenous injection, or other medicine. Diuretics have to buck the effects of this disease often accompanied cerebral edema, should adopt quick impact powerful diuretic. (3) Acute renal failure: a small number of acute renal failure and dialysis are indications, should promptly gave dialysis treatment to help patients overcome the acute phase. As a self-healing tendency of the disease, renal function can be gradually restored, general does not require long-term maintenance dialysis. 7, generally do not have other treatment adrenal cortex hormones. The medical treatment of serious oliguria invalid or no urine, high cycle congestive state beyond the control of hypertension and dialysis treatment available. 8, in the medical treatment of Chinese medicine that the more true card, according Syndrome can be divided into cold, wind-heat, hot and humid, were given to Xuanfei diuretic, such as Liangxue detoxification therapy. The disease is still convalescent Qingre Lishi mainly佐以Yangyin not to fill wetlands. Prognosis The vast majority of patients in 1-4 weeks, a diuretic, swelling, blood pressure, urine tests also often result improved. Serum C3 in 4-8 weeks to return to normal, most pathological examination also resume normal or only legacy mesangial cell proliferation. However, a small amount of microscopic hematuria and trace protein sometimes can be deferred six months to a year before disappearing. Only less than one percent of patients with acute renal failure may be due to improper treatment of the death, and mostly elderly patients. Long-term prognosis of the disease each reported mixed, but the majority of cases are of the view that good prognosis can be completely cured, about 6% -18% of cases left over from urine abnormalities and (or) to hypertension and chronic, or "clinical cure "After many years there glomerulonephritis performance. Generally considered elderly patients, the sustainability of high blood pressure, proteinuria or renal dysfunction, poor prognosis and distributed to the most popular are poor prognosis; renal tissue hyperplasia lesions heavy, with more crescent formation had poor prognosis.