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Nephritic syndrome


The nephritic syndrome is an inflammation of balls of kidneys with azotemia signs, that is decrease in glomerular filtering, at  the expressed proteinuria, a hamaturia and a delay in an organism of salts and liquid with the subsequent development of arterial hypertension. It is necessary to distinguish a nephrotic syndrome and nephritic syndromes. Both of them are not the diagnosis, and only define a state at various diseases. If to define generally, then the nephrosis is the general definition of damages of kidneys, and nephrite is an inflammation of kidneys. Sometimes the nephritic syndrome is defined as a glomerulonephritis, but it is wrong as the nephritic syndrome can be as manifestation of a glomerulonephritis, but it not one and too as it can be manifestation and other diseases. The nephritic syndrome is not a disease and not the diagnosis, it is set of the symptoms similar to nephrite acute is more often.

The nephritic syndrome happens acute, subacute and chronic.

Схема строения почечного канальца

Scheme of a structure of a renal tubule

Symptoms of the Nephritic syndrome:

Usually the syndrome demonstrates one-two weeks later after manifestation of symptoms of a streptococcal infection if it is the reason.

Classical manifestation of a nephritic syndrome:

    * In 100% of cases there is a hamaturia (blood in urine).
    * The gross hematuria, urine becomes colors as meat slops, appears only at 30% of patients.
    * At 85% of patients hypostases are formed. They can be distinguished from "cardiac" hypostases manifestation time. At a nephritic syndrome to the second half of day it is formed swelled a face, especially in the field of a century, and by the evening swelled legs. At heart diseases, hypostases are formed in the morning and pass at the movement.
    * At 82% of patients arterial hypertension which together with increase in volume of the circulating blood, lead to development of left ventricular acute failure that is shown in the form of increase of pulse (cantering rhythm) and to a fluid lungs is observed.
    * The gipokomplementemiya develops in 83% of cases.
    * Oligoanuriya in combination with feeling of thirst is observed at 52% of patients.

Carry to nonspecific symptoms:

    * Nausea, vomiting, weakness and as a result development of anorexia.
    * Headaches against the background of anorexia and the weakened organism.
    * Very seldom there is a temperature increase.
    * Back pains and/or in a stomach.
    * Symptoms of scarlet fever or impetigo.
    * Increase in body weight.
    * Symptoms of respiratory diseases of infectious character, including pharyngitis and acute tonsillitis.

Reasons of the Nephritic syndrome:

In model of development of a nephritic syndrome, practically there is always post-streptococcal or any other form nephrite. At what, from all streptococci, only the V-hemolitic streptococcus can become the reason of development of a nephritic syndrome.  Usually the syndrome, even acute, begins to develop gradually and, usually imperceptibly, at some stage of nephrite and only under the influence of some external factors, for example overcooling, streptococcal quinsy and so on, begins to be shown violently. Such beginning of a nephritic syndrome call acute as symptoms arise suddenly, but it is necessary to understand that development occurred for certain much earlier. In certain cases process accrues gradually and then it is about a subacute nephritic syndrome. If symptoms are shown, disappear with various interval of time, usually in several months and even each half a year, is considered to be such nephritic syndrome chronic recurrent.
The second reason of development of a nephritic syndrome various autoimmune diseases, for example a system lupus erythematosus, a vasculitis and so on can. The nephritic syndrome develops in a consequence of accumulation on a basal membrane of cells of balls of a complement.
The strengthened excretion of ions of hydrogen or toxic factor of noninfectious character can also become the reason of formation of a nephritic syndrome.

Factors which can provoke development of a nephritic syndrome can be divided on:

    * Virus: infectious mononucleosis, hepatitis B, Koksaki's viruses, chicken pox, epidemic parotitis, ESNO and other.
    * Bacterial: sepsis, typhoid, endocarditis, pneumococcal or meningococcal infections and so on.
    * Post-streptococcal and not post-streptococcal glomerulonephritis.
    * Other types of a postinfectious glomerulonefit when the syndrome develops against the background of already available infection. Diagnosis of nephrite in this case is much more difficult as various damages of kidneys and system manifestations often imitate absolutely other diseases, for example a nodular polyarteritis or a red system lupus.
    * Autoimmune general diseases: Shyonlayna-Genokh's disease, system lupus erythematosus, vasculites, pulmonary and renal hereditary syndrome and other.
    * Primary diseases of kidneys: mezangiokapillyarny or mesangioproliferative glomerulonephritis, Berger's disease and so on.
    * The mixed reasons: radiation, syndrome Hyena Barra, introduction of vaccines and serums and other.

It is necessary to understand that development of a nephritic syndrome at any disease, always demonstrates deterioration and an exacerbation of primary disease.

Treatment of the Nephritic syndrome:

There is no specific treatment of a nephritic syndrome per se. The main therapy is a treatment of a basic disease. The diet No. 7a which consists in restriction of proteins and salt is surely appointed.
In the presence of an infection appoint antibiotics. To lower OTsK appoint diuretics under calcium control.
At arterial hypertension apply APF inhibitors, diuretics and blockers of calcium channels.
If the renal failure develops, then dialysis and/or transplantation of kidneys is shown.

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