Chronic nephrite
Chronic nephrite – the disease developing as a result of not cured acute nephrite.
The disease, as a rule, as a result of long impact on kidneys of the infectious centers develops. Chronic nephrite can sometimes develop also without acute stage of nephrite in the past. First of all, the chronic nature of a disease depends on existence of infections in an organism, insufficient treatment in the past of acute nephrite and unfavorable conditions of the environment.
At chronic nephrite in kidneys there are anatomic changes leading to formation of cellular exudate in capsules (a so-called semilunum), to widespread defeat of vessels of kidneys, degenerative changes of a canalicular epithelium. All listed changes lead to a zapustevaniye of separate balls and a granular kidney as a result of an atrophy of some sites of a renal parenchyma eventually.
Course of chronic nephrite
During chronic nephrite it is necessary to allocate such stages:
- Stage of renal compensation, sufficiency of azotovydelitelny function of kidneys. As a rule, this stage is followed by such symptoms of chronic nephrite as hypostases, a hamaturia, an albuminuria, increase in arterial pressure. Sometimes these symptoms carry not expressed character, only the albuminuria takes place.
- Stage of a renal decompensation, insufficiency of azotovydelitelny function of kidneys. At this stage the amount of protein can fall in urine, hypostases can also decrease, however the hypertension becomes, on the contrary, steadier. The main symptoms of chronic nephrite at this stage are initial insufficiency of kidneys and increase in blood of slag nitrogen. Azotemic uraemia is characteristic of this stage.
As a rule, outcome of chronic nephrite deadly. Duration of disease is various and can fluctuate within 1-20 years and more. Death can come also from a hematencephalon, heart failure, from consecutive infections, etc.
Types of chronic nephrite
- Subacute ekstrakapillyarny nephrite. Formation of cellular exudate in a cavity of capsules is characteristic of this form. Approximately in half a year after the beginning of a disease the persistent hypertension and a persistent hamaturia is shown. It is quite often possible to observe such symptoms of chronic nephrite as persistent hypostases, existence of an azotemia, the accruing anemia, high concentration in blood of creatinine and aromatic connections, and also uraemic symptoms which as a result lead to the fact that by the end of the first two years of a disease the patient dies.
- Nephrotic chronic nephrite. Such symptoms of chronic nephrite as persistent hypostases, a considerable albuminuria and normal arterial pressure are characteristic of this look. Anatomically intracapillary nephrite with nephrotic changes of tubules is characteristic of this look. Hypostases are not followed by a Jacob's ladder and an asthma, amplify from reception of salty food and can keep a long time (from several months to several years). If patients throughout the long edematous period do not die of infections, then there comes the period bezotechny, characterized by the general improvement of a condition of the patient. However this temporary phenomenon, and comes further death from chronic true uraemia.
- The mixed chronic nephrite. Persistent hypostases of lipoid and nephrotic type, increase in arterial pressure and cardiovascular symptoms are characteristic of this type of nephrite. Afterwards the renal failure joins these signs. As a rule, patients die as a result of heavy chronic uraemia. Also death from a hematencephalon, heart failure and infections is characteristic of this form of chronic nephrite.
- Chronic nephrite of hypertensive type. This type of a disease can proceed a long span almost asymptomatically. A characteristic sign are only hypertensive symptoms arising usually at an idiopathic hypertensia (vascular spasms, paresthesias, spasms of gastrocnemius muscles, etc.). Anatomically it is possible to observe intracapillary nephrite with strong indications of a sclerosis of small arteries. This disease usually is found absolutely accidentally when passing inspection. Chronic nephrite of this look can last many years then at the patient the picture of chronic true uraemia develops.
Prevention of chronic nephrite
Prevention of chronic nephrite first of all consists in prevention of nephrite in an acute form, its early diagnosis, timely and adequate treatment.
The course of chronic nephrite can be facilitated by carrying out the rational mode and treatment of focal infection, to detain thereby approach of a stage of the renal failure which is not giving in to treatment.
Treatment of chronic nephrite
Long since at chronic renal diseases of the patient a certain hygienic mode was recommended: wearing woolen linen, the strengthening not irritating food, accommodation in a warm and arid climate. At treatment of chronic nephrite patients should avoid overcooling, a heavy exercise stress, stressful situations, drugs irritating kidneys and the excessive use of food. All these actions are directed not only to creation of optimal conditions for work of the damaged body, but also for the facilitated activity of all organism in general.
In case of an inflammatory exacerbation of a disease, developing of severe hypostases, weakening of a cardiac muscle and at manifestation of uraemic symptoms patients need a bed rest.
At treatment of chronic nephrite of nephrotic type appoint an electrolyte-deficient diet, protein-rich, Thyreoidinum, mercusal. In case of complications streptococci and pneumococci appoint penicillin, sulphonamide drugs. Stay in a warm and arid climate and reception of heart and vasodilating medicines is shown to the patient.
If the infection center is found, to the patient treatment of chronic nephrite by means of sulphonamide drugs and penicillin, physiotherapeutic methods is appointed. In case of satisfactory function of kidneys to the patient can recommend to carry out surgical intervention. Removal of the infectious center aims to stop before itself toxi-infectious impact on an organism, and also to eliminate action of a source of nervnoreflektorny irritation.
At treatment of chronic nephrite to the patient appoint glucose solution under skin and inside in large numbers for the purpose of counteraction of uraemic intoxication. At emergence of symptoms of uraemic acidosis to the patient appoint alkalis and use of alkaline saline solutions.
Bloodletting favorably influences at manifestation of hypertensive and vascular symptoms. Against separate symptoms of uraemia use the drugs influencing the centers of a brain.
There are very curious medical syndromes, for example, persuasive swallowing objects. In a stomach of one patient suffering from this mania 2500 foreign objects were revealed.
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