Chronic nephritis and differential diagnosis

Typical diagnosis of chronic nephritis It is not difficult, for the young and middle-aged men in general most were slow onset, protracted illness. Abnormal urine checks are often proteinuria, hematuria can be accompanied by edema and hypertension. May have varying degrees of renal impairment. Diagnosis of chronic nephritis with other kidney disease screening method roughly the same, and, in particular to recommend some patients do kidney biopsy, further defined pathological diagnosis, treatment and prognosis of the disease is helpful. There is generally a pathological diagnosis of the following types: mesangial proliferative glomerulonephritis (with IgA nephropathy), mesangial proliferative glomerulonephritis, membranous nephropathy, focal segmental glomerular sclerosis, often at the same time varying degrees of renal small ball sclerosis, renal vascular sclerosis lesions tubular atrophy and fibrosis and inflammatory cell infiltration, and to the development of advanced, we can see that size decreased kidney, renal cortical thinning. Chronic glomerulonephritis symptoms and the incidence of many diseases and have varying degrees of similarity, therefore, in practice should be seriously identification, in order to symptomatic treatment. Chronic nephritis major diseases should be differentiated from the following: 1, chronic nephritis and chronic pyelonephritis Identification Chronic pyelonephritis the clinical manifestations of chronic nephritis may be similar, but have asked in detail about the history of urinary tract infection (particularly women), more leukocytes in urine, can interleukin type, positive urine culture, intravenous pyelography and nuclear Renal examination two kidneys of the degree of damage ranging from the performance. These are beneficial in the diagnosis of chronic pyelonephritis. 2, chronic nephritis with lupus nephritis Identification Lupus nephritis and renal clinical histological changes were similar and chronic nephritis. Systemic lupus erythematosus in women but most were and as a systemic disease, can be accompanied by fever, rash, arthritis and other impaired performance system. Decreased blood cells, immunoglobulin increase can be found lupus cells, anti-nuclear antibody positive, serum complement levels decline. Renal histological examination showed extensive calmly immune complexes in the various parts of the glomeruli. Immunofluorescence inspection "Full-" performance. 3, chronic nephritis and kidney damage identification of essential hypertension Sustained increase in blood pressure with chronic nephritis essential hypertension with renal damage identification, the latter often in the age of onset of 40 years of age, hypertension before a change in the urine, urinary protein often is not serious renal tubular dysfunction and more obvious. Heart, brain and retinal vascular sclerosis vascular changes often more apparent. Some patients with chronic nephritis refractory hypertension, the higher the blood pressure in general, the longer the duration, the more serious condition, the prognosis is poor. And malignant hypertension more common in middle-aged man suffering from hypertension, in the short term often caused renal insufficiency, and chronic nephritis is easy to confuse with hypertension. Malignant hypertension blood pressure is higher than chronic nephritis, often 29/17 kP (200/130mmHg) or higher. However, the early onset of urinary not obvious change more, in less urinary protein, no hypoproteinemia, or edema. Malignant hypertension because of the small atherosclerosis is systemic necrosis, and it a high degree of common retinal arteries narrow, hardened with bleeding and bleeding, as papillary edema, heart expanded cardiac dysfunction than obvious that these can be made Kam basis. 4, the other primary glomerular diseases (1) occult glomerular nephritis: clinical light chronic nephritis with misprision of glomerulonephritis type of identification, the latter mainly for asymptomatic hematuria and proteinuria, no edema, hypertension and renal dysfunction . (2) acute nephritis after infection: a precursor to the infection onset of acute and chronic nephritis be differentiated from the disease. The incubation period of two different serum C3 will help identify the dynamic changes; In addition, the vesting of different diseases, chronic nephritis no tendency to self-healing, a chronic progress can be funded distinction.