Uric syndrome
Contents:
Description:
The uric syndrome (asymptomatic disturbances of composition of urine) includes in broad understanding all quantitative and qualitative changes of urine, in narrower — changes of an urocheras: proteinuria, erythrocyturia, leukocyturia.
Symptoms of the Uric syndrome:
Changes in urine - a microhematuria, a leukocyturia, a cylindruria and a proteinuria less than 3,5 g/days take place.
The most frequent forms of an uric syndrome - the isolated hamaturia, the isolated proteinuria and the isolated leukocyturia.
Reasons of the Uric syndrome:
The isolated hamaturia (without proteinuria and a cylindruria) happens the only symptom of a tumor of uric ways, a stone of uric ways or infections of uric ways (for example, tuberculosis of uric ways), and also occurs at defeat of renal nipples at patients with a nephropathy at drepanocytic anemia and an analgetic nephropathy.
If in urine find the cylinders containing the erythrocytes or cylinders containing pigments - derivatives gem, then the hamaturia reason - damage of nephrons. Such hamaturia without proteinuria is characteristic of a high-quality family hamaturia and an IgA-nephropathy.
Its combination to a proteinuria meets at many diseases of the kidneys leading to HPN. As a rule, in such cases the forecast is worse, than at the isolated hamaturia or the isolated proteinuria.
For identification of a source of the constant isolated hamaturia resort to excretory urography and a tsistoskopiya, is more rare - to renal arteriography.
The isolated proteinuria (without erythrocytes and other uniform elements in an uric deposit) meets at many diseases of kidneys when the inflammation in balls is minimum or is absent (a diabetes mellitus, an amyloidosis). Easy forms of the diseases causing a nephrotic syndrome can be shown by a moderate proteinuria (less than 3,5 g/days).
The canalicular proteinuria is characteristic of a cystinosis, poisoning with cadmium, lead and mercury, and also of the Balkan local nephropathy - the rare disease widespread in small area on Danube.
Leukocyturia which happens isolated too, - a sign of an inflammation of uric ways, but not a renal parenchyma. Nevertheless the expressed leukocyturia (as a rule, in combination with a small proteinuria or a hamaturia) develops at any inflammatory damage of kidneys, is more often at tubulointerstitsialny nephrite and lupoid nephrite, pyelonephritis and rejection of a renal transplant.
Diagnosis is especially difficult when against the background of a leukocyturia the result of crops of urine is negative. Possible reasons of a sterile leukocyturia:
- infection of uric ways, treated germicides;
- treatment by glucocorticoids;
- acute feverish diseases;
- treatment by cyclophosphamide;
- pregnancy;
- rejection of a renal transplant;
- injury of uric ways or injury of generative organs;
- prostatitis, cystitis and urethritis and
- all forms of tubulointerstitsialny nephrite.
Leukocytes can get to urine from vulval separated therefore for identification of a leukocyturia it is necessary to investigate an average portion of the urine taken in aseptic conditions.
Leukocyturia in combination with a proteinuria, erythrocyte and other cylinders - a sign of an inflammation of balls, tubules, an interstitium or a microcirculator bed of kidneys therefore at inspection specify not so much a leukocyturia source, how many the nature of defeat of a renal parenchyma.
There are also other, more rare reasons of a constant sterile leukocyturia which consider in differential diagnosis too. Among them - the tuberculosis and infections caused by the atypical mycobacteria, mushrooms, Haemophilus influenzae, anaerobic bacteria, L-forms of bacteria and bacteria growing only on special environments.
Treatment of the Uric syndrome:
Carry out treatment of a basic disease.
