Specific renal parenchymal disease
Introduction
Introduction to specific renal parenchymal diseases The most common causes of nephrogenic acute renal failure are: acute or rapid glomerulonephritis, acute interstitial nephritis and toxic nephropathy. The etiology is still unclear. Specific renal parenchymal diseases include acute tubular necrosis and acute cortical necrosis. The latter is caused by intravascular intravascular coagulation, and no urine can occur, and the prognosis is poor. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of infection: non-infectious Complications: sepsis, dehydration, urinary tract obstruction
Cause
Specific cause of renal parenchymal disease
The etiology is still unclear. Specific renal parenchymal diseases include acute tubular necrosis and acute cortical necrosis. The latter is caused by intravascular intravascular coagulation, which can cause anuria and poor prognosis. During the Second World War, Lücke first described A group of patients with acute tubular necrosis after crush injury and shock, he believes that the distal renal tubular changes - Near nephron nephrosis is caused by ischemia.
Prevention
Specific renal parenchymal disease prevention
No effective precautions.
Complication
Specific renal parenchymal disease complications Complications sepsis dehydration urinary tract obstruction
The following conditions were combined: 1 sepsis or dehydration; 2 urinary tract obstruction; 3 isolated kidney.
Symptom
Specific symptoms of renal parenchymal disease Common symptoms Sore throat, sputum pain in the kidney area, left and right waist pain, kidney area, tenderness, hematuria, systemic persistent edema, dull pain in the kidney area
Symptoms and signs: Patients usually have a history of sore throat or upper respiratory tract infection. They have used antibiotics or other nephrotoxic drugs. Even bilateral low back pain or even severe pain may occur. There may be gross hematuria.
Pyelonephritis is rare in acute renal failure unless the following conditions are combined: 1 sepsis or dehydration; 2 urinary tract obstruction; 3 isolated kidney.
Systemic diseases that cause acute renal failure include: Henoch-schonlein purpura, thrombotic thrombocytopenic purpura, systemic lupus erythematosus and scleroderma, and human immunodeficiency virus (HIV) infection can cause HIV nephropathy, which can be acute Renal failure, the patient's prognosis is extremely poor.
Examine
Specific renal parenchymal disease examination
Laboratory inspection:
1 urine: a large number of red blood cells, white blood cells and a variety of cell or particle tube types can be seen under the microscope. Eosinophils are seen in the urine of patients with allergic interstitial nephritis. The sodium concentration is 10 to 40 meq/L.
2 Blood: During the deposition of immune complexes, serum complement components are reduced. Under certain conditions, circulating immune complexes can be detected. Other tests can find systemic diseases such as lupus erythematosus and thrombotic thrombocytopenic purpura.
3 renal biopsy: renal biopsy will show the characteristic pathological changes of acute interstitial nephritis or glomerulonephritis. Extensive crescent formation can be seen in the glomerular capsule.
X-ray inspection:
An intravenous urography or an isotope kidney scan can be manifested as poor development. Because contrast agents have a nephrotoxic effect, routine intravenous urography should be avoided. Ultrasound is the best way to rule out urinary tract obstruction.
Diagnosis
Diagnosis and identification of specific renal parenchymal diseases
Diagnosis can be based on medical history, clinical symptoms, and laboratory findings.
Should be differentiated from diseases such as urinary tract obstruction.
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