Jade: Symptoms and Treatment
Jun 19, 2018
The kidney is a very important organ that supports the chemical homeostasis by means of urine formation and excretion, removes toxic substances and excess fluid from the human body.Any violation in the work of the kidneys is a great danger to health, therefore almost all diseases of this organ are considered serious.Jade is no exception.
Generally nephritis is a generalized name for a large group of renal diseases , each of which has its own causes, mechanisms of development and symptoms.The only common feature for all of them is the presence of an inflammatory process in one of the structural parts of the kidney.Table of contents: Classification of nephritis Causes of nephritis development What happens in the kidneys with tubulointerstitial nephritis?Nephritis: symptoms Diagnosis Treatment of jade Dispensary observation Prevention
Classification of nephritis
Depending on the part of the kidneys affected, the following types of nephritis are distinguished:
- Glomerulonephritis, in which glomeruli are affected.
- Pyelonephritis is an inflammation of the renal calyxal apparatus.
- Tubulointerstitial or interstitial nephritis, in which kidney tubules and the surrounding tissue - interstitium - are involved in the pathological process.
In terms of the vastness of the lesion nephritis is focal and diffuse, in nature of the course - acute and chronic.
In addition, there are several other types of nephritis: the so-called lupus nephritis( manifestation of systemic lupus erythematosus) and hereditary nephritis of the kidneys, which are mostly affected by men, and manifests the disease already in childhood( the development of pathology is associated with mutations in the genes of some proteins).
Causes of development of nephritis
Let's consider in detail the causes of tubulointerstitial nephritis, and we recommend reading about pyelonephritis and glomerulonephritis here.
The development of acute interstitial nephritis can be caused by various factors, but among them the main role is played by taking medicines:
- Antibiotics( aminoglycosides, cephalosporins, fluoroquinolones, etc.).
- Drugs against tuberculosis.
- Non-steroidal anti-inflammatory drugs( indomethacin, etc.).
- Analgesics( this includes the popular paracetamol among the population).
- Immunosuppressive drugs.
- Hypotensive drugs( in particular captopril).
- Allopurinola( a drug used for gout and urate stones in the kidneys).
This list can be continued for a long time.Potentially dangerous can be many medications, and the probability of developing nephritis depends not so much on their dose as on individual sensitivity of a person.Therefore, to predict what will be the reaction of the kidneys to a particular medicine is very difficult, especially since often jade develops only after repeated use of the drug.
Significantly increase the risk of drug jade disease of the liver, kidney, immune disorders, old age, stagnation in the body( eg, heart failure).
In addition, nephritis can develop due to intoxication with ethanol( alcohol), ethylene glycol poisoning( this substance is a part of antifreeze, solvents, brake fluid) and other chemical compounds to which a particular person will be sensitive.
Possible causes of nephritis include radiation exposure and infectious diseases( especially diphtheria, leptospirosis, tuberculosis, syphilis, toxoplasmosis, cytomegalovirus infection, etc.).
When the cause of the disease is revealed to doctors and can not, diagnose acute idiopathic tubulointerstitial nephritis.
Chronic nephritis has several different mechanisms and development factors. In most cases, the chronic form of the disease is the result of untreated acute nephritis.Less often the disease develops independently, for example, with prolonged abuse of medicines, especially analgesics and nonsteroidal anti-inflammatory drugs that are sold without prescriptions and are very often used by people without prescribing a doctor.In addition, chronic nephritis can occur against the background of cancer.
What happens in the kidneys with tubulointerstitial nephritis?
Immune mechanisms play the leading role in the development of acute tubulointerstitial nephritis. Toxic substances or other pathogenic agents interact with the protein structures of the renal tubules, which makes the immune system perceive them as foreign antigens and begins to release antibodies.As a result of these processes, an inflammatory reaction develops, which leads to interstitial edema, narrowing of the tubules, increased blood pressure in them, impaired blood flow in the kidneys, and reduced glomerular filtration.As a result, the kidneys cease to fully perform their basic function( to filter the blood).
Chronic nephritis in the absence of the acute phase of the disease develops not because the immune system damages the kidneys, but more because of metabolic disorders and the toxic effects of chemicals on the kidneys.
Acute interstitial nephritis usually occurs suddenly.The following symptoms appear in patients:
- General weakness, malaise, worsening of appetite.
- Polyuria( increased amount of excreted urine).
- Blunt pain in the kidney area.
- Fever, but rarely.
- Pain in the joints and muscles.
- Allergic rash on the body.
- Arterial hypertension( short).
- Dry mouth.
- Edema, but not always( the appearance of puffiness is more typical of acute severe nephritis, in which polyuria gives way to anuria - stopping the excretion of urine by the kidneys).
With chronic nephritis, the symptoms described increase gradually.
Survey of patients with symptoms of nephritis usually includes:
- Mandatory laboratory tests of : general and biochemical blood tests, various urine tests( including Zimnitskiy, Nechiporenko), bacteriological culture of urine, blood testOn electrolytes.
- Obligatory instrumental studies of : ultrasound of kidneys with dopplerometry, monitoring of arterial pressure, ECG, ultrasound of internal organs.
- Additional diagnostic tests of : biochemical analysis of urine, immunological studies, radioisotope study of kidneys, determination of excretion( excretion) of electrolytes and uric acid.
In severe cases, when doctors fail to diagnose nephritis on the basis of the results of a routine examination and determine its cause, a kidney biopsy is performed.This method makes it possible to establish the diagnosis with great accuracy.
In addition, to identify hidden foci of infection in the body( possible sources of pathogenic microorganisms that cause inflammation of the kidneys) during the examination of patients may require consultations of physicians of various specialties( infectious disease specialist, otolaryngologist, dentist, gynecologist, etc.).Immediately the treatment of patients with nephritis should not only deal with nephrologists or urologists, but also immunologists, since the main mechanism of the development of the disease, as already mentioned above, is the immune mechanism.
Treatment of jade
Treatment of jade is performed in a specialized hospital .Patients are shown bed rest, which can only be expanded after a decrease in the activity of the pathological process( confirmed by the results of the tests and the patient's well-being), and dietary nutrition( diet No. 7, 7a and 7b).The main thing in this diet is the restriction of the use of salt, spicy and flavored food, and if there is a significant violation of kidney function, the protein is also.
Medical treatment of nephritis includes several important areas:
- Elimination of the cause of inflammation. If the disease is caused by a drug, its reception is canceled, and a drug is introduced into the body that can bind the residues of the dangerous substance in the blood.With severe intoxication and cumulation of drugs, hemosorption, plasmapheresis is carried out.If the cause of jade is an infection, antibiotics or antiviral drugs are used.
- Effect on the mechanisms of the development of the disease .Used desensitizing( antihistamines), hormones, drugs that improve kidney blood flow.
- Elimination of the symptoms of the disease .Correction of water-electrolyte and other disturbances is carried out.Intravenous solutions are introduced, the amount of urine released is controlled, if necessary, diuretics are used, medicines to normalize the pressure.If the kidneys do not cope with their function and do not remove the metabolic products from the body( this is determined by blood tests), hemodialysis( blood purification with the help of special equipment) is performed.If there is no possibility of hemodialysis, peritoneal or intestinal dialysis is performed.
With the timely commencement of treatment, a patient with nephritis can fully recover( without any residual effects).If the anti-inflammatory and detoxification therapy is not carried out, it is possible to develop acute renal failure - a deadly complication.In addition, in case of improper treatment, non-compliance with the patient's recommendations, the acute process gradually turns into chronic, which is fraught with the appearance in the subsequent chronic renal failure.That is, a person becomes disabled.
All patients who underwent interstitial nephritis need to monitor the kidneys.There is a control in a regular visit to the nephrologist( twice a year), the delivery of urine and blood tests.The duration of such medical examination is 5 years.
The main measure of prevention of interstitial nephritis is the careful handling of medicines. You can not take drugs without prescribing a doctor, you can not experiment with dietary supplements, you can not increase the doses of medications prescribed by a doctor, you can not take pain medications every time you have pain, you can not drink herbal preparations of unknown origin( for example, teas for weight loss), etc.If, however, because of the state of health( the presence of the pain syndrome) you have to constantly take analgesics or non-steroidal anti-inflammatory drugs, you should always consult a doctor, find the cause of the pain and eliminate it, rather than "smooth out" the symptoms.
Zubkova Olga Sergeevna, medical reviewer, epidemiologist-doctor