Ten syndromes of nephropathy
First, Acute glomerular nephritis syndrome
These include acute glomerulonephritis and other diseases
1, have disease urgent
2, there is a history of infection
3, three signs: besides proteinuria, there are three signs of "edema, hematuria and hypertension"; In other cases, there may be less urine, more than one sex nitrogen, and severe cases of pulmonary congestion and pulmonary edema.
Test: anti-streptococcal haemolysin O (ASO) > 500U/ml, the complement of C3 drops;
Note: when urine volume decreases more than a week, the course of more than two months no improvement condition, renal biopsy should be done, with the accelerated nephritis, secondary kidney disease, IgA nephropathy, allergic purpura nephritis, etc.
Second, acute glomerulonephritis syndrome
1, have disease urgent
There are also three signs of nitrogen and nitrogen, which are characterized by rapid deterioration of renal function in the short term.
3, pathological type, crescent glomerulonephritis specific pathology can be pided into three types: (1) anti glomerular basement membrane antibody nephritis, (2) immune complexes nephritis, without glomerular basement membrane antibody in serum, b check ANCA positive (3) ANCA nephritis (less immune complex type)
Third, chronic glomerulonephritis syndrome
1, the history is long, mainly in albuminuria; Many of them have been transformed by acute glomerulonephritis;
2, edema is either absent or not
High blood pressure or no
The presence of or without nitrogen
There are two kinds of causes, including primary and secondary;
Primary includes: The atherosclerosis of the foci segment; Glomerular arteriosclerosis; (4) membranous; The ability to increase reproduction; 6. IgA nephropathy; The sex of the crescent;
Secondary includes: systemic lupus erythematosus; Allergic purpura nephritis; Diabetic nephropathy; (4) starch kidney; The type of rheumatoid secondary kidney damage; Hereditary kidney disease. The prognosis is poor.
Common type: light, medium proteinuria, urine RBC > 10 / HP;
Hypertensive type: low blood pressure, moderate elevated, especially diastolic blood pressure, often accompanied by kidney failure and poor prognosis.
Kidney disease: the "three high and low" manifestations of nephrotic syndrome (hyperedema, hyperalbuminuria, hyperlipidemia, hypoalbuminemia).
Hybrid: including the first three
Fouth, Nephrotic syndrome
High edema, hyperproteinuria, hyperlipemia, hypoalbuminemia, white protein below 30 g/L
2, 24h urine protein quantified >, 3.5 g/L.
3, note: 1) diet: avoid high-protein, high-fat;
2) distinction: original and secondary; Other congenital, inherited kidney disease;
3) the diagnosis: first rule out the secondary, then the original, the two treatments are different;
A, The types of pathology include: a, tiny lesions: the most sensitive to hormones;
B, membrane: immune inhibitors are not sensitive, and some of them can be alleviated automatically, often in adults; The kidney, the heat of the heat is more prominent, and the four magic is effective.
C, membrane reproduction:
D, hardening of the focal arteries; The presence of hematuria and renin hypertension;
E, membrane-forming; There is blood urine.
5th, Urinary abnormality syndrome
Haematuria: the urinary tract infection of the elderly requires an examination -- the symptoms are often not obvious;
To determine the area of hemorrhage: three experiments in urine;
Urine red blood cell form: renal hematuria is polymorphic (the deformed red blood cells account for more than 80 percent);
The hematuria form of haematuria in the urinary tract infection is homogenous (the average is more than 80 percent).
Between the two -- mixed blood urine;
Acute nephritis -- cold blood to stop the bleeding; Chronic nephritis - the FDP (-) cools the blood; The FDP (+) bled blood
Proteinuria: a disc electrophoresis (qualitative); The urine is free.
6th, acute renal failure
1, There is a clear history of disease.
2, the disease is urgent, the progress is quick, the disease is heavy, the death rate is high.
3, Clinical fractal type: low urine type, non-urinary type;
4, Diagnosis: to exclude prerenal factors (loss of blood, fluid, shock);
Excluding the factors of kidney (stone, tumor, enlarged prostate, urinary retention);
Nephrogenicity (renal substance, renal cortical necrosis) :
5, Clinical pision 3: the shorter urinuria: the shorter the time, the better the prognosis;
Urea: the amount of rehydration = 2/3. (3) recovery.
7th, Chronic kidney failure
It deals with multiple systemic lesions: renal anemia, depression, stomach disease, diarrhea, encephalopathy, hypertrophy, cardiomyopathy.
8th, Urethral stimulation syndrome
Causes - 1, mental factors;
2, infection: a group of bacteria, mold; The urine high permeability can raise the positive rate.
Gram-negative bacteria in the majority; Alkaline urine is easily sterilized;
Erythromycin is resistant to drug-resistant strains;
In the case of drug susceptibility, antibacterial therapy was used.
3, chemical factors
9th, Chronic interstitial nephritis syndrome
1, Edema, hypertension, and proteinuria are rare; Early common dry, nocturia, and secondary anemia (the secretory of the renal tubule cells secreted by erythrin, the renal tubules atrophy, causing the reduction of erythrin, and anemia); In the late stage, you may have edema and high blood pressure;
2, the symptom is not outstanding, easy leak diagnose. There have been a number of symptoms of chronic renal insufficiency, such as renal diabetes, amino acid urine, reduced urine weight, or urinary collapse.
Attention to several aspects: the chronic urinary tract infection
10th, High blood pressure nephrotic syndrome
Kidney hypertension, kidney and capacity;
For high blood pressure, look for the cause and exclude other possible factors:
1, side without pulse, blood vessel murmur, elevated blood pressure, proteinuria, multiple aortic inflammation, oral blood clotting, or stent placement;
2, Low blood potassium, high blood pressure -- the discovery of adrenal gland can give an oral or surgical treatment. There is no adrenal gland tumor, which is known as bartter's syndrome, or
3, pseudoaldosterone, which is a genetic disease of the family.
Trimester hypertension, kexingshi.