Glomerulonephritis

Glomerulonephritis is immune-inflammatory renal disease with obligatory glomerulus's injury and including to the pathological process of all renal structures.

In more cases glomerulonephritis is an independent nozological form but may be a result of systemic pathology or pathological states.

Classification

I. Acute glomerulonephritis

1. According to the variant:

- with urinary syndrome;

- with nephritic syndrome;

- with hypertension syndrome;

- mixed.

2. According to the duration:

- recidivated;

- lingering.

II. Subacute glomerulonephritis

III. Fast advance glomerulonephritis

IV. Chronic glomerulonephritis

1. According to the variant:

- with urinary syndrome;

- with nephritic syndrome;

- with hypertension syndrome;

- mixed;

- latent.

2. According to the stage:

- anhypertensive;

- hypertensive;

- renal failure:

• the period of anuria/oliguria;

• the period of diuresis reparation;

• the period of complete renal function reimbursement.

3. According to the duration:

- stable;

- progressive.

4. According to the phase:

- remission;

- aggravation.

Etiology

1. Influence of infection agent (primary streptococcus);

2. Endogenous antigens:

- systemic connective tissue diseases;

- systemic vasculitis;

- diabetes mellitus I or II type;

- viral hepatitis B or C type;

- the syndrome of arterial hypertension;

- later hystosis;

- other reasons.

3. Exogenous antigens:

- alcohol;

- toxic substances;

- poisons;

- bite of animals and insect;

- drugs.

4. Hereditary origin.

Acute glomerulonephritis

Acute glomerulonephritis is acute immuno-inflammatory renal disease with obligatory glomerulus's injury and afterward including to the pathological process of all renal structures.

Acute nephritis typically arises not during an infectious disease but only following a period of time, usually 2-3 weeks later. Attempts to isolate the streptococcus from the kidney tissue end in failure. Thus, the onset of acute nephritis usually coincides with the period when antibodies to streptococcus are produced.

Clinical features

The main complaint in patients with acute glomerulonephritis are weakness, thirst, pain in the back, dyspnea, palpitation, headache, nausea, vomiting, edema and lost of vision.

Objective examination: General patient's condition is from moderate grave to extremely grave. In general inspection detect "faces nephritica" - the face is edematous and often pale. Swelling usually appears first around the eyes in the morning and eyes may become slit like when edema is pronounced.

The color of the skin characterized by pathological pale, observed decreased turgor and elasticity of the skin, scars on the abdomen and hips due to the over stretching of the skin.

Edema in patients with nephritic syndrome (edema renalis) characterized by symmetrical localization, in initial stages arises on the face in the morning, has descending character and spreads on extremities, loin region with next fluid accumulation in cavities (hydrothorax, hydropericardium and anasarca). The skin over edema is glossy.

The apex beat is somewhat shifted to the left. In heart percussion observed displacement of the left border of the heart to the left. In heart auscultation detects tachycardia and gallops rhythm. Arterial pressure is increased.

Complications: acute renal failure, acute heart failure, encephalopathy, stroke, eclampsia, transitory vision impair.

Outcomes of disease: complete recovery, transformation to the chronic form.