Immune nephritis

Introduction Immune nephritis is a chronic glomerular disease of the kidney that is caused by various causes. Also known as primary immune nephritis, clinically secondary chronic kidney damage caused by systemic diseases such as diabetes, systemic lupus erythematosus, gout, etc., named after the primary disease, such as diabetic nephropathy, lupus nephritis, etc. . Because the diagnosis and treatment of these cases are mainly based on systemic diseases (such as diabetes), the incidence of immunological nephritis in China is still very high. The incidence rate in China in 1981 was 0.28-0.89%, which is the most important cause of chronic renal failure. One (60%). The immunological nephritis caused by different causes is similar in symptoms, and the disease is mainly caused by immune reaction.

Cause

The etiology of most immune nephritis is still unclear. Studies have shown that various microorganisms, including bacteria, viruses, rickettsia, protozoa, etc., can cause the disease through the immune pathogenesis. In particular, viral infections may be the cause of most immune nephritis. Renal lesions caused by drugs, metabolic disorders, autoantibodies, etc., are only part of systemic damage and are secondary renal lesions.

an examination

Related inspection

Immunopathological examination of renal function test

First, the possibility of immunological nephritis should be considered when the following conditions occur in the clinic.

1, edema with abnormal urine test, including proteinuria, tubular urine.

2, hypertension and abnormal urine test.

3, fatigue, weakness, loss of appetite, extreme anemia and other combined urine test abnormalities.

4, unexplained hematuria.

5. Unexplained urine abnormalities are found during routine urine tests for physical examinations or other diseases.

Second, immune nephritis generally needs to do the following checks to confirm the diagnosis:

1, urine protein quantification and selectivity index determination or urine protein immunochemical analysis.

2, the identification of urinary red blood cell morphology, immune nephritis is generally polymorphic.

3, kidney function test, to understand whether there is kidney damage.

4, measure blood pressure, check the fundus, observe whether there is high blood pressure and fundus changes.

5. Analysis of plasma protein and blood lipids.

Differential diagnosis

Differential diagnosis of immune nephritis:

1, functional proteinuria: especially orthotopic proteinuria, not uncommon in adolescents. To rule out this situation, qualitative, quantitative and immunochemical analysis of proteinuria in the position should be performed. Postural proteinuria should not present edema, hypertension, and impaired renal function.

2, exclude secondary nephritis, such as systemic lupus erythematosus, diabetes, drugs or chemicals and kidney damage caused by tumors.

3, and chronic pyelonephritis, chronic pyelonephritis is not glomerular disease, but interstitial nephritis. Chronic interstitial nephritis rarely causes a large amount of proteinuria, and urine protein is quantitative.

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