The main manifestations of Glomerulonephritis: fatigue, back pain, anorexia, gross hematuria, edema, hypertension, renal dysfunction, decreased urine output (oliguria in some patients), congestive heart failure, specific clinical manifestations of the disease, please see the appropriate disease entry.
Polyuria, polydipsia, nausea, nocturia, hematuria, muscle weakness, flaccid paralysis, joint pain and other symptoms.According to the clinical manifestations of the disease, can be attributed to the traditional Chinese medicine "gonorrhea", "blood", "Diabetes" and "infirmity closed", "virtual work" permit category.Interstitial nephritis, acute and chronic, symptoms vary.
1, acute interstitial nephritis
Acute interstitial nephritis due to different causes and different clinical manifestation, is not specific.Mainly characterized by oliguria or non-oliguria acute renal dysfunction may be associated with non-specific performance such as fatigue, fever and joint pain.Renal tubular function in low proportion of losses and low osmolality urine, tubular proteinuria and water, electrolyte, and acid-base balance disturbance, performance for Fanconi syndrome in some patients.
2, chronic interstitial nephritis
Chronic interstitial nephritis is often latent, chronic or acute onset, due to changes in renal interstitial chronic inflammation, mainly for fibrosis tissue hyperplasia of renal tubular atrophy, so often the common clinical manifestations.
Chronic Reflux nephropathy:
Clinical manifestations of this disease varies.Episodes of urinary tract infection and symptom severity has nothing to do with levels of reflux and renal scarring, only a history of infection cases may also have severe reflux.Incidence of childhood urinary tract infection for the first time, regardless of their age, sex and severity of symptoms, and shall carry out the relevant checks.Children under 4 years of age onset, recurrent urinary clinic.Medical patients, mostly women, young people, mostly because of unilateral renal atrophy, renal failure, urinary symptoms, high blood pressure treatment.
The most common clinical manifestation of the disease is urinary tract infection and occurs in the flank pain when urinating.63%~88% incidence of urinary tract infections;The incidence of proteinuria was 34, 5%~54, 7%, or RN first symptoms often appear in serious scarring after a few years, saying the VUR is leading to Glomerular lesions, for indications of a poor prognosis.Even if the VUR disappeared after surgery, renal function continues to deteriorate.In addition, the characteristics of this disease has the potential, often due to urinary tract infections during pregnancy, protein in urine or renal failure, hypertension, pre-eclampsia is found for the first time.Inpiduals occasionally Imaging for other reasons, and found a single kidney or bilateral renal scar or shrink or discover and take into account the diagnosis of asymptomatic bacteriuria.Some patients may be asymptomatic for a long time, until into renal insufficiency uremia period to diagnosis.
Cystic kidney disease:
For the disease when young kidney size normal or slightly larger with age increases gradually and continuously increasing the number and size of the cyst and, in most cases, renal volume grew to a considerable degree to 40~50sui symptoms, characterized by enlarged kidney on both sides, kidney pain, hematuria, hypertension, and so on.
1, renal enlargement: nephropathy is not symmetrical on both sides, size differences, to late renal can occupy the entire abdominal cavity surface has a lot of kidney cysts, kidney-shaped irregular, uneven, hard texture.
2, kidney pain: for their symptoms, often for lower back pressure or dull pain, and pain, and sometimes abdominal pain, pain can be caused by physical activity, walking for too long, long wait for aggravated after bed rest reduces renal hemorrhage, stone moves is the reason for sudden pain or infection.
3, hematuria: about half of patients with microscopic hematuria, can have episodic hematuria, caused by the rupture of the cyst wall, bleeding time blood clots through the ureter can cause colic, hematuria, proteinuria and often accompanied by white blood cells in urine, urine protein less, generally not more than 1, 0g/d, kidney infection, pyuria clear urine increased back pain accompanied by fever.
4, and hypertension: for ADPKD of common performance, in serum muscle anhydride not increased zhiqian, about half appeared hypertension, this and cyst oppression around organization, activated kidney pigment-vascular tension pigment-aldehyde solid ketone system about, near 10 years to, Graham PC,Torre v and Chapman AB, are confirmed this disease kidney within normal organization, cyst near between quality and the cyst epithelial cell kidney pigment particles increased, and has kidney pigment secretion increased, these on cyst growth and hypertension of occurred is closely related to, in other words, Occur with hypertension, cyst is growing rapidly, can directly affect the prognosis.
5, and renal dysfunction: this disease will suffer from renal insufficiency, renal failure in inpidual cases during adolescence appears, usually before the age of 40 are few renal insufficiency, renal function in about half remained at the age of 70, but shorten the process of developing high blood pressure and kidney failure, there are also inpidual patients 80 years old can still maintain kidney function.
6, polycystic liver disease: found in middle-aged patients with ADPKD, about half have Polycystic liver disease, after the age of 60 is about 70%, generally considered its slow development and more kidney about 10 years later, the cyst is formed by the lost bile duct dilation, and pancreatic and ovarian cysts may also occur, colonic perticula complicated with a higher rate.
7, cerebral arterial circle Hemangioma: the hemangiomas are 10%~40%, often caused by blood vessels ruptured aneurysm, cerebral hemorrhage a further check was found, in addition, thoracic aortic aneurysms and heart disease (such as heart valve insufficiency and prolapse) are also common.
Adult type more SAC kidney General in adult early appeared symptoms, often to hematuria, hypertension or kidney function not full onset, abdominal touch diagnosis can found larger of more SAC kidney, kidney function more is slow for sex decrease, hypertension, obstruction or pelvis nephritis, is accelerated kidney function damage of important reasons, often chromosome hidden genetic type (baby type) more SAC kidney onset Yu baby period, clinical more rare, more in baby period death, very minority light syndrome who can live to adult.
This disease often compared with other causes of anaemia levels of uremic anemia light, its causes are kidney cysts generally produce erythropoietin.
Nephrotic syndrome in the elderly:
This disease often infections (tonsillitis, pharyngitis or upper respiratory tract infection), or of cold, tired, onset can be acute and sustained and sometimes insidious onset, the main performance:
1 edema: a systemic, attempt, denting edema, initially in the ankle, morning when the eyelids, facial edema, with progression, edema can be all over the body and the chest, abdominal and scrotal effusion or pericardial effusion, edema can occur in serious in elderly patients with heart failure.
2 and macroalbuminuria: proteinuria > 3, 5G/24h, which were more than 10 grams, proteinuria is characterized by selective or non-selective.
3, hypoalbuminemia: reduce plasma total protein, mainly albumin decreased, mostly in the 10~30g/L (1~3G/DL), occasionally reduced to 5, 8g/L (0, 58g/DL).
4, Hyperlipidemia: most patients blood cholesterol, phospholipids and triglycerides can be increased 4 points, proteinuria and hypoalbuminemia as a prerequisite for diagnosis.
1, without clinical proteinuria proteinuria in diabetic kidney disease, only to be detected by Radioimmunoassay method of urinary micro-albumin.Early only for clinical diabetic nephropathy and proteinuria, proteinuria developed gradually from the intermittent to persistent.
2 clinical diabetic nephropathy generally no edema, and edema, a few patients in front of a plasma protein decreased, with mild edema.If proteinuria, low plasma proteins, edema, increased, as the disease progressed to advanced performance.
3 no nephropathy, hypertension in type 1 diabetes the prevalence of hypertension is more normal does not increase, more patients with type 2 diabetes mellitus with hypertension, but if proteinuria high blood pressure also increased when, in case of nephrotic syndrome patients with hypertension, hypertension in this mostly moderate, severe minority.
4, the progress of renal failure of diabetic nephropathy there is a big difference.Some patients with mild proteinuria can persist for years, but with normal renal function and proteinuria rarely in some patients, rapid development of nephropathy syndrome, kidney function deteriorated, culminating in uremia.
5, obvious azotemia patients anemia, may have mild anaemia.
6, cardiovascular disease and other complications such as congestive heart failure, myocardial infarction.Neuropathy such as peripheral neuropathy.Autonomic nerves can occur when involvement of neurogenic bladder.Retinopathy, severe almost 100% complicated by retinopathy of diabetic nephropathy, renal lesions in severe retinopathy may not necessarily be obvious.When the progress of diabetic nephropathy, retinopathy is often accelerated deterioration.