Nephritis

　　Nephritis is an immune-mediated inflammatory reaction of the kidney, which is caused by different antigens and microorganisms infecting the human body, producing different antibodies, combining into different immune complexes, and depositing in different parts of the kidney, causing pathological damage and forming different types of nephritis. The main causes of nephritis include the following points:

　　1. Infection:The main causes are bacterial, viral, and parasitic infections, which are the most common causes of nephritis. Especially common cold, asymptomatic bacteriuria, influenza, pharyngitis, tracheobronchitis, and other diseases can trigger nephritis.

　　2. Taking medicine arbitrarily:Most of the drugs entering the body are excreted from the body through the kidneys, and some drugs may cause serious damage to the kidneys, such as antipyretic and analgesics, certain antibiotics, traditional Chinese medicines containing aristolochic acid or valerian, certain traditional Chinese patent medicines, and so on. Therefore, drugs must be used under the guidance of a doctor, and should not be used arbitrarily to avoid irreversible damage to the kidneys.

　　3. Overexertion:Including overwork, such as: heavy physical labor and intense exercise, staying up late, even sexual overexertion, etc., are all causes of nephritis.

　　4. Arteriosclerosis:With the increase of age, kidney function naturally declines, and arteriosclerosis is also an important cause of renal function damage. Therefore, people over the age of 40 should pay attention to their kidneys, and it is best to check urine routine and renal function annually.

　　5. Other:Such as electrolyte and water imbalance, acid-base imbalance, etc., which can cause acute exacerbation of chronic nephritis.

　　Nephritis has a strong hidden nature, and if not treated in time, it can trigger serious complications.

　　1. Anemia:Anemia is the most common complication in patients with nephritis. In the late stage of chronic nephritis, renal parenchymal damage can lead to various abnormalities in the blood system, such as anemia, abnormal function of lymphocytes, abnormal function of platelets, and coagulation disorders, etc. The main reasons for anemia include reduced erythropoiesis, increased destruction of red blood cells, and increased blood loss, etc.

　　2. Infection Infection as a malignant stimulus factor often triggers acute exacerbation of chronic nephritis, aggravating the condition progressively. Long-term proteinuria leads to the loss of a large amount of protein, malnutrition, and immune function disorder, which are prone to various infections, such as respiratory tract infection, urinary tract and skin infection, etc.

　　3. Hypertension The incidence of hypertension in patients with chronic nephritis reaches 80%. In the renal insufficiency stage of chronic nephritis, serious cardiovascular complications often occur, such as hypertension, atherosclerosis, myocardial disease, pericarditis, and renal insufficiency, etc.

　　4. Acute Renal Function Failure During the acute phase of acute nephritis, mesangial cells and endothelial cells in the glomeruli proliferate in large numbers, capillaries become narrow, and intravascular thrombosis occurs, leading to further reduction in urine output. Large amounts of protein decomposition products accumulate, and uremia syndrome may occur during the acute phase.

　　Nephritis is an inflammatory lesion of both kidneys. Some people may miss the best opportunity to treat the disease due to not knowing the symptoms of nephritis, resulting in serious consequences. The main symptoms of nephritis include:

　　1. Prodromal Symptoms　Patients with nephritis often have a history of respiratory or skin infections 1-3 weeks before the onset of nephritis, such as measles, acute pharyngitis, skin pustulosis, tonsillitis, gingival abscess, etc., but some patients with nephritis may also not have prodromal symptoms.

　　2. Hematuria Most patients with nephritis begin to have oliguria, even anuria, accompanied by gross hematuria, and microscopic hematuria persists.

　　3. Edema　Patients with nephritis may develop edema when they have oliguria at the beginning, mainly on the face and lower limbs, and are generally accompanied by fatigue, lumbar pain, increased foam in urine, and abnormal urine color, etc.

　　4. Hypertension　Some patients may have hypertension at the onset of the disease, and some may develop hypertension during the course of the disease, manifested as symptoms such as headache, decreased memory, poor sleep, etc. Once the blood pressure increases, it is persistent and not easy to decrease spontaneously.

　　5. Infection Acute glomerulonephritis and chronic glomerulonephritis patients often have acute exacerbations associated with pharyngitis, tonsillitis, upper respiratory tract and skin infections, etc. When suffering from the above infectious diseases, routine urinalysis should be checked.

　　6. Renal Function Damage　The renal function damage of nephritis patients is persistently worsening, with a significant decrease in glomerular filtration rate and tubular dysfunction occurring simultaneously.

　　While actively treating nephritis, patients should also pay attention to preventing the deterioration of the condition in their daily lives.

　　1, Do a good job of keeping warm in winter Since blood vessels are prone to contraction at low temperatures, blood pressure increases, urine decreases, and the kidneys are easily damaged. The condition of nephritis patients is prone to deterioration, so nephritis patients should pay attention to keeping warm in winter.

　　2, Regular check-ups Nephritis patients should pay attention to regular check-ups, it is best to do urine and blood urea nitrogen tests every six months, especially women during pregnancy may increase the burden on the kidneys, so it is necessary to monitor renal function to prevent the occurrence of uremia due to pregnancy toxemia.

　　3, Do not overeat and overdrink Nephritis patients should pay attention not to overeat and overdrink. If the diet contains a lot of protein and salt, it will increase the kidney burden and cause the condition to worsen.

　　4, Treat the common cold in a timely manner After a cold, nephritis patients must receive timely treatment to prevent the exacerbation of nephritis. Those with symptoms such as hypertension and edema should go to a regular nephropathy hospital for examination.

　　5, Prevent tonsillitis If the tonsils of nephritis patients are infected, they must be completely cured, otherwise it may lead to kidney inflammation.

　　6, Do not take medicine randomly Now there are many painkillers, cold remedies, and traditional Chinese medicine that have toxic effects on the kidneys. Nephritis patients should not take medicine randomly to prevent the deterioration of nephritis.

　　Since nephritis is generally quite insidious and symptoms are not very obvious, it is easy to be ignored by people and not receive timely treatment, leading to serious consequences. The examinations that nephritis patients need to do include:

　　1, Blood routine The count of red blood cells and hemoglobin may be slightly low, due to the expansion of blood volume and dilution of blood. The count of white blood cells may be normal or increased, which is related to whether the primary infection focus continues to exist. Erythrocyte sedimentation rate accelerates, and it usually returns to normal within 2 to 3 months.

　　2, Urinalysis The urine color is generally normal, the amount of protein in the urine is usually not much, and the number of white blood cells in the urine sediment increases (in the acute phase, it is often full of the field of vision, in the chronic phase, 5 per high-power field), and sometimes white blood cell casts may occur.

　　3, Renal function examination Most patients may have a transient decrease in creatinine clearance rate, with increased creatinine and blood urea nitrogen. After treatment, it generally恢复正常 relatively quickly.

　　4, Cytological and serological examination The positive rate of β-hemolytic streptococcus isolated from the throat or skin infection foci of nephritis patients after onset is about 30%, and it is more difficult to detect in those who receive penicillin treatment early.

　　5, X-ray examination When nephritis recurs frequently or symptoms in the chronic stage are difficult to control, X-ray examination should be used for diagnosing nephritis, including abdominal X-ray, intravenous pyelography, and micturition cystography. It is necessary to exclude the presence of stones, kidney下垂, congenital malformations of the urinary system, and other diseases.

　　6, Ultrasound or CT examination Some patients may show an increase in kidney volume.

　　After the onset of nephritis, patients should pay attention to their diet. Unreasonable diet often tends to increase the kidney burden of nephritis patients, causing further damage to renal function and leading to a continuous deterioration of the condition.

　　1. Limit potassium intake During the treatment period, patients with nephritis should avoid eating foods high in potassium, such as fresh mushrooms, shiitake mushrooms, jujube, shellfish, beans, vegetables, and fruits.

　　2. Limit salt and water The initial symptom of nephritis in patients is edema, and the kidneys cannot normally excrete water and sodium. Limiting water intake and avoiding salt are good methods to eliminate edema. In addition to not adding salt or soy sauce, it is also necessary to avoid foods with high sodium content.

　　3. Limit spicy foodssuch as anise, pepper, etc., the metabolic products of which contain purines, are excreted by the kidneys, and can increase the burden on the kidneys, so they should not be eaten excessively; animal liver, kidneys, and other internal organs contain a lot of nucleoprotein, and their metabolic products contain a lot of purines and uric acid, so they should also be eaten less.

　　4. Eat light and easily digestible food Patients with nephritis need to eat more light and easily digestible foods and avoid seafood and beef and mutton. If these foods are consumed excessively, they will increase the burden on the kidneys, and more fresh fruits and vegetables can be eaten.

　　If nephritis is not treated in a timely manner, it may lead to kidney failure and even threaten life. The Western treatment of nephritis mainly focuses on rest and symptomatic treatment, and it is not advisable to use hormones and cytotoxic drugs.

　　1. General treatment. Bed rest should be maintained before肉眼血尿disappears, edema subsides, and blood pressure returns to normal. A low-salt diet should be provided.

　　2. Antimicrobial treatment. Patients with acute nephritis should receive adequate antimicrobial treatment when there is an infectious focus. Generally, it is advisable not to use it when there is no infectious focus.

　　3. Symptomatic treatment with diuretics, edema reduction, and blood pressure lowering. Common thiazide diuretics (such as hydrochlorothiazide 25mg, twice to three times a day) are used as needed. If diuretics such as furosemide 20-60mg/d are required, they can be administered by injection or in divided doses orally. If the blood pressure is still not satisfactory after diuresis, calcium channel blockers such as nifedipine 20-40mg/d can be added, taken in divided doses orally or vasodilators such as hydralazine 25mg, three times a day. However, potassium-sparing diuretics (such as triamterene and spironolactone) and angiotensin-converting enzyme inhibitors should be used with caution in oliguria to prevent the induction of hyperkalemia.