Glomerulonephritis: classification. Kidney inflammation. Kidney surgery

Inflammation of the kidneys, which is characterized by damage to the filtering apparatus, is commonly called "glomerulonephritis" in medicine. The classification of pathology depends on the sources of the onset of the disease, the specific nature of the course. In most cases, with this disease, the glomeruli of the kidneys are damaged. However, the pathological process can include other parts of the kidneys: tubules, intercellular tissues. Most often the disease is diagnosed in children under 12 years old. However, one can not exclude the risk of developing the disease in adulthood.

Characteristics of the disease

What is glomerulonephritis? This is a number of various ailments, which are characterized by inflammatory damage to the kidneys. Most often, they are triggered by the negative impact of infectious or allergens.

The pathology is manifested by the defeat of the glomerulus, the renal tubules, and also the vessels. To understand in more detail what a disease is, one should touch on anatomy. Kidney glomeruli perform one of the most important functions in the body. They filter and remove toxins, excess liquid, decay products and other unnecessary substances.

Glomeruli are localized in the body of the kidney. They represent a cluster of capillaries of a loop-like appearance. In a normally functioning organism, the blood moves along the bringing arterioles. Then it penetrates into the renal glomerulus. Here, filtration takes place and urine is formed. All spent, unnecessary substances are screened out in the musculature canaliculus. From it, they enter the cavity of the kidney, and then into the bladder. Blood, free from unwanted impurities, leaves the glomerulus along the outgoing arteriole.

A slightly different picture is observed if a person develops glomerulonephritis. This is a pathology characterized by increased patency of the renal filter. As a result, the required function is not fully implemented. In the urine can penetrate large structures: protein, red blood cells, leukocytes. And these components are vital to the body. Progression of the disease leads to a deterioration in blood purification. Excess fluid and harmful substances are not eliminated from the body.

Most often, the disease is based on the body's reaction to a variety of infections or allergens. But sometimes the pathology is autoimmune. In this case, the disease develops against the background of damage to the kidneys by their own antibodies.

Causes of the disease

Why can glomerulonephritis arise? Classification to some extent depends on the cause of the disease.

The main sources of glomerulonephritis are the following factors:

1. Streptococcal infection. This is the most common catalyst for the disease. Most often, kidney damage is caused by improper therapy of streptococcal angina. To cure such pathology, it is necessary to undergo a full course of antibiotic therapy prescribed by a doctor. To kill streptococcus by other methods is impossible. And if the infection is not completely eliminated, then after 10-14 days acute poststreptococcal glomerulonephritis can develop. With this pathology, the body itself begins to attack the kidney cells.
2. Viral infection. It can also provoke a relapse of the disease.
3. Cold. An ailment complicated by inflammation of the kidneys.
4. Systemic pathology of connective tissue. The development of glomerulonephritis can be based on rheumatoid arthritis, systemic lupus, nodular periarthritis, vasculitis.
5. Chronic bacterial or viral infections. Pathology can develop against a background of viral hepatitis B, C, syphilis, infective endocarditis, malaria.
6. Metabolic diseases. Glomerulonephritis can be caused by amyloidosis, diabetes mellitus, urate nephropathy, gout.
7. Diseases of the blood. Its role in the development of the disease can play a lymphogranulomatosis, myeloma, chronic leukemia.
8. Toxic factors. Becoming triggers for the development of glomerulonephritis can be the abuse of drugs, drugs, alcohol; Impact on the body of mercury, lead, solvents, certain types of poisons (for example, bees, snakes). At the heart of the appearance of the disease may lie radiation sickness, severe hypothermia, vaccination.

Symptomatic of the disease

Sometimes pathology can be asymptomatic. Doctors say that in almost half of the patients who are diagnosed with glomerulonephritis, the disease is detected only through a medical examination. And the patients themselves do not even suspect the development of such a serious infectious disease in the body.

If glomerulonephritis makes itself felt, then the symptomatology will be as follows:

1. Puffiness. It manifests itself on the face, eyelids. Swelling can occur on the lower and upper limbs. The weight of an adult as a result of such symptoms sometimes increases in 7 days by 25 kg.
2. Oliguria. There is a decrease or a complete absence in the patient of urine.
3. Dyspnea. Such symptoms in severe course can lead to pulmonary edema.
4. Hematuria. The urine acquires a reddish hue. This is dictated by the presence of blood in it.
5. Arterial hypertension. The patient is tormented by a persistent increase in pressure.
6. The presence of protein in the urine. This is provoked by increased capacity of the kidney glomeruli during blood filtration.
7. Increased temperature.
8. Pain sensations in the lumbar zone are bilateral.
9. Constant thirst.
10. Vomiting, the presence of nausea. Lack of appetite.

And now let us consider what are the varieties of such a pathology as glomerulonephritis.

Classification of the disease

Pathology is divided into different characters. That is why there are several of its classifications.

So, let's recall why glomerulonephritis occurs. Classification of the ailment by sources of appearance will be as follows:

1. Primary glomerulonephritis. The kidneys are affected by pathogenic factors.
2. Secondary. The disease develops against the background of existing pathologies in the body.

By the nature of the course of the disease can be:

• Acute - newly emerged;
• Subacute - pathology lasts a couple of weeks or several months;
• Chronic - the disease lasted a year, and sometimes a longer period.

According to the degree of diffusion:

• Diffuse process that covers the entire filtration system;
• Focal lesion.

Forms of the disease

Given the nature of the symptoms, doctors classify the disease as follows:

1. Latent form. Pathology proceeds secretly. The patient has episodic erased symptoms. Most often this form is characteristic of a subacute species.
2. Cyclical. Characterized by acute inflammation. The patient has severe symptoms. As a rule, there is a rapid recovery. However, this form often recurs.

Types of pathology

One of the main characteristics of the disease is the clinical form. Clarification of the disease is carried out taking into account the prevailing symptoms.

The following types of glomerulonephritis are distinguished on the basis of characteristic features:

1. Nephrotic. Is swollen.
2. The hematuric. The inflammatory process is combined with the symptoms of changes in the urine. There is proteinuria, hematuria in moderate amounts.
3. Hypertensive. Dangerous form. It is characterized by a persistent increase in pressure. Complications caused by hypertension can form.
4. Mixed. With this form, nephrotic-hypertensive symptoms are combined. The pathology is quite unfavorable.

There is one more classification - according to morphological symptoms:

1. Focal-segmental inflammatory process of glomeruli. For pathology is characterized by rapid sclerosis of the renal capillaries.
2. Mesangioproliferative nephritis. The most common type of ailment. Pathology is characterized by the deposition of immunological complexes to certain pathogens from antibodies.
3. Membrane nephropathy. Thickened capillary walls of the glomerulus contain protein-expressed plaques.
4. Mesangiocapillary glomerulonephritis. The working tissues of the glomeruli are subjected to diffuse sclerosing. As a result, they are replaced by connective cells. Pathology is characterized by an unfavorable scenario.

Consider in more detail some varieties.

Sharp appearance

This pathology begins suddenly and has the most commonly expressed symptoms. Acute diffuse glomerulonephritis is characterized by fever, hyposthenuria, polturia and hematuria, the presence of low back pain. Pathology can be bacterial, drug, immune or viral.

Subacute form

Pathology has another name - malignant glomerulonephritis. It is characterized by rapid development. The patient has the same symptoms as in an acute type.

However, all signs of the disease are more pronounced:

• Swelling;
• Decrease in the amount of urine;
• headache;
• pallor;
• dyspnea;
• Change of color of urine;
• weakness;
• Palpitation;
• Increase of pressure.

The disease is diagnosed on the basis of a blood test, urine.

Membranous glomerulopathy

This form is characterized by a diffuse thickening of the glomerular capillary membranes. Most often, pathology is associated with infection. More susceptible to this type of ailment of a man. They have membranous glomerulonephritis characterized by a slow onset. In addition, the disease is accompanied by nephrotic syndrome and proteinuria.

Pathology can be complicated by renal chronic insufficiency, vein thrombosis, which can cause peripheral thromboembolism.

Treatment of the disease

To combat the disease, complex therapy is undertaken, combining:

• Drug treatment;
• Adherence to a strict diet (table number 7a);
• Bed rest (with relapse or acute leakage).

In most cases, such methods allow you to quickly stop the acute course of the disease. In the subsequent patient, a recovery therapy is selected.

But sometimes the disease is characterized by a severe course. In this case, the patient is assigned hemodialysis. This allows you to protect the patient from severe complications of the disease. A special device, called an "artificial kidney," purifies the blood of toxic compounds, excess fluid, and electrolytes. It is recommended for those patients who developed renal failure in a chronic form against a bilateral lesion.

Kidney surgery

Chronic glomerulonephritis can lead to quite unpleasant consequences. One of them is renal failure. And if the "artificial kidney" is able to help in the initial stages (in the bilateral process), then when the process is started, the question of transplantation becomes acute. It consists in transplanting the organ from the donor.

The kidney operation is performed only after a thorough examination of the patient. It should be noted that transplantation has its contraindications. In addition, difficulties may arise with the selection of a donor kidney.