Which factors are associated with prognosis of chronic nephritis

Chronic glomerulonephritis will develop into renal failure after years unhealed, but the rate of progress come different in different people. We can not cure this disease fundamentally at present, while if we have the ability to prolong their renal function for years or decades, provide their chances to live and work normally, it is not only highly beneficial for patients and their families, but also for the society. Accordingly, those factors connected with progressing speed turn into focus to people. Here are some factors that already known.

1. Pathological factors. Different pathological change, different prognosis. For example, compared to severe mesangial proliferative glomerulonephritis and membrano proliferative glomerulonephritis, prognosis of simply mild mesangial proliferative glomerulonephritis is better. 50% Membrano proliferative glomerulonephritis develop renal failure in 10 years, chronic renal disease generally progress slowly and have good prognosis, few develop renal failure in 5 years, while focal segmental glomerulosclerosis has poor prognosis and usually develop into uremia in 10 to 20 years. In addition, other pathological factors affecting prognosis are: the crescent, the poorer prognosis is; patients with obvious or severe lesions on vessels inside kidneys like fibrinoid necrosis of small arteries have poor prognosis; patients with interstitial fibrosis and tubular atrophy have poor prognosis.
2. Clinical factors. ① patients have history of hemolytic streptococcus infection before have better prognosis;② who do not have other clinical symptoms except proteinuria or hematuria have better prognosis; ③ who have severe high blood pressure or high blood pressure progressing rapidly have poor prognosis, while patients can control the high blood pressure by medicines have better prognosis; ④ patients with little urine protein volume after treatment have better prognosis than those who have more or normal urine protein volume; ⑤ who with obvious anemia and edema have poor prognosis.
If you have any questions about kidney disease, you can believe that Beijing United-tech Nephrology Specialist Hospital is the best choice. And you can also contact us online.

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Common causes of uremia

Uremia has a high incidence in our daily life and pose dramatically danger to our life. If someone reaches the stage of uremia, he or she is likely to confront great challenges both in physical function and mental health. So all the people should attach much importance on uremia in order to detect it early and treat it timely. In order to grasp it completely, we should find out common causes of uremia. Followings are some causes you can refer to.

1. Primary glomerulonephritis: if nephritis like membranoproliferative glomerulonephritis, rapidly progressing nephritis, membraneous nephritis and focal glomeruloscerosis are left untreated for a long time, they are likely to develop uremia.
2. Secondary glomerulonephritis: henoch-schonlein purpura nephritis, systematic lupus erythenlatosus nephritis, hypertension nephritis and diabetic nephropathy will step in uremia in the long run, because they can damage kidneys to varying degree.
3. Congenital and hereditary kidney disease: polycystic kidney, hereditary nephritis and all kinds of congenital renal tubular dysfunction can lead to uremia occur because of the impairment to kidneys’ ability to filter waste products.
4. Infectious disease: chronic pyelonephritis and nephrotuberculosis may also lead to occurrence of uremia, because such disease may affect other organs surround kidney and so as to the overall body.
5. Urinary tract blocked: kidney stone, bilateral ureteral obstruction, and narrow urinary tract will lead to waste products retaining in blood, increase burden of kidney, such condition will finally develop into uremia.
6. Other factors: some types of drug, heavy metal and keep on diet to lose weight all have great chance to induce uremia.
In general, no matter what the cause is, patients should observe what doctors instruct and take treatments as soon as possible in order to seize the best opportunity to protect kidneys.

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Is lipid-lowering medicine useful to kidney disease

Hyperlipidemia is closely associated with kidney disease, it is a common clinical manifestation of a lot of primary or secondary kidney disease (CKD), at the same time itself is involved in the occurrence and development of kidney disease.

Hyperlipidemia not only increase the incidence of cardiovascular disease, but also accelerate the progress of kidney disease, so the lipid-lowering therapy has certain protective effect to kidney. Large numbers of studies recently have shown that statins have a number of roles except lipid-lowering,including anti-inflammatory, immunomodulatory and directly inhibit mesangial cell proliferation and mesangial matrix increase, which with no doubt is of great significance to slow down the progress of kidney disease. It is well recognised that hyperlipidemia is the third major factor besides high blood pressure and albuminuria, which can promote the progression of kidney disease.
Nephrotic syndrome, diabetes kidney disease and end-stage renal disease patients often have lipid metabolic abnormalities involved, the latter not only cause arteriosclerosis, promote the kidney disease progress, but also can increase the incidence of cardiovascular complications. Lipid-lowering drugs like statins can significantly reduce the morbidity and mortality of cardiovascular events, whether with coronary or not, whatever basic lipid level is, statins can significantly reduce 23% of major vascular events. Which means statins is beneficial to improve the long-term prognosis of patients with ESRD. What’s more, statins is mainly excreted from liver and its renal excretion rate is less than 0.5%, which make statins relatively suitable for patients with kidney disease. In addition, studies have shown that it is safe and effective for patients with hypercholesterolemia nephrotic syndrome and hemodialysis to take statins constantly.
In view of all the above effects, statins can be widely used in many kinds of treatments in kidney disease, such as hyperplastic glomerulonephritis, ischemic renal disease, chronic kidney disease and polycystic kidney，etc.

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What is the pathogenesis of diabetic nephropathy

The pathogenesis of diabetic nephropathy is very complicated, realizing it can be beneficial for people to keep their eyes on precautions and nursing in the daily life. Next we will introduce three main pathogenesis for people to refer to.

Genetic background. Diabetes is a polygenetic disease, no matter type 1 diabetes or type 2, there is a high relationship with individual’s genetic background whether people will get diabetic nephropathy or not. Someone who has blood glucose and blood pressure under control still suffer from diabetic nephropathy, while someone even though not control blood glucose and blood pressure well, they never experience diabetic nephropathy, which implies that individual’s different genetic backgrounds have different susceptibility to diabetic nephropathy. The incidence of diabetic nephropathy also depends on racial and ethnic, for instance, Asian people have a higher incidence of kidney disease than Caucasians.
1. Hemodynamic changes. Hemodynamic has already changed at the early stage of diabetic nephropathy, it plays an important role in the formation of diabetic nephropathy. Hemodynamic changes are mainly reflected in high perfusion, high filtration and high pressure within the glomerulus, all of these factors make glomerular work under the higher load, if this situation lasts long, glomerular will become fat, the open areas of vasoganglion will increase, basement membrane of blood vessel will become thicken and permeability increase, and then it will proceed to proteinuria and glomerular sclerosis which eventually promote the formation of diabetic nephropathy.
2. Metabolic disorder and insulin resistance. The most basic pathological change of diabetes is sugar metabolic problems, in this situation sugar in the body is higher than the normal range. Unfortunately, blood sugar and high glucose in the blood is toxic, called the“toxic sugar”, which is mainly because too much glucose may activate some substance which is harmful to kidney, it is thus that cause the diabetic nephropathy.
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Clinical manifestations of chronic glomerular nephritis syndrome？

Chronic glomerulonephritis(chronic nephritis) syndrome refers to a group of similar clinical manifestations which have diverse etiology and different pathological form. It is important to learn about the clinical manifestations of chronic nephritis because of its hidden causes and mild symptoms that are easily to be overlooked at the early stage. Next i will list some common symptoms summarized by senior experts from Beijing United-Tech Nephrology Specialist Hospital.

1. Edema. In the whole course of the disease, most patients will appear to have different degree of edema, and many patients start with edema. Patients with mild edema only show edema on eyelid, faces after getting up in the morning, but it can subside after a few hours. But if you want to tell it from the edema caused by lack of sleep or staying up late, you should do a urine test to make sure whether it is nephritis.
2. Hypertension. Some patients go to see doctor because of hypertension, and urine test is the only necessary means to find out nephritis. For patients with chronic nephritis, hypertension will occur sooner or later. The increasing of blood pressure can be either persistent or intermittent, and it usually implies that the lesions have reached a certain degree. What’s more, the degree of blood pressure is closely associated with prognosis, generally the higher your blood pressure is, the longer it lasts, the more dangerous you will be and the worse of the prognosis.
3. The abnormal urine test. Chronic kidney disease patients’urine test will be surely abnormal, including the abnormally reasonable amount of urine and abnormal microscopic examination.The urine volume of the patients with edema will be reduced, and the more serious of the edema,the more urine he will reduced.Generally, if the patients do not have edema, his urine volume will be normal
4. Renal insufficiency. Chronic nephritis patients will have the symptoms of dizziness, insomnia and mental fatigue. Moreover, when patients’ renal function decreases, they will feel less of appetite, fatigue resistance, different degrees of anemia and other symptoms.
Above symptoms can either come together or alone, if patients can not have them under control, they are very likely to develop renal failure or even uremia. So patients should pay more attention to symptoms in the daily life.

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What are the causes of hypertensive nephropathy?

Kidney disease can be divided into a lot of kinds, and high blood pressure is one of them. The damage to patients with this disease is pretty big, so everyone should take it seriously, especially the patients with this disease, must pay attention to the disease and learn more about the relevant knowledge of the disease. Then what are the causes of hypertensive nephropathy?

1. Long-term high blood pressure.
Hypertension is a serious disease, it will directly cause kidney pathological changes if not controlled for a long period, such as glomerular sclerosis and renal interstitial fibrosis which can lead to kidney function decline or finally develop into hypertensive nephropathy. Patients should take their blood pressure frequently and keep their blood pressure within the normal range and better take low salt, low fat food.
2. Unreasonable diet.
Many diseases have a direct relationship with diet, no matter the healthy group or disease group, regular and controlled diet is often suggested. Generally the onset of kidney disease is very slow, which need us require ourselves strictly like eating less food that are bad for kidney.
3. Bad living habits in the daily life.
Generally speaking, smoking and drinking are two factors most threatening to our body, it can also aggravate the high blood pressure and the damage to kidney function. Besides, emotion, staying up late, overtired and drug abuse all have chances causing hypertension nephropathy.
According to the causes above, everyone should pay more attention to their own living habits and diet, thus can not only do good to your whole body, but also make contribution to your kidney function.

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How to identify whether the urine bubbles are caused by disease or not

The formation of urine bubbles is mainly related to the surface tension of the urine liquid. In general, the higher the liquid surface tension is, the easier it is to form bubbles. It is more likely to form bubbles due to the surface tension of the urine liquid increase when the urine components change, such as protein, mucus and organic substance increase. Usually, the occasional bubbles in the urine are more likely to be physiological but not pathological, which can get better itself. Next we will introduce some types of urine bubbles caused by disease.

1. Proteinuria. Abnormal elevation of protein in the urine is one of the most common causes, it is also an important clinical manifestation of various diseases, especially the kidney disease. All kinds of primary renal disease, such as various types of primary glomerular nephritis and secondary kidney damage, all can lead to proteinuria increase due to the kidney damage. While with regard to non-urinary system disease such as multiple myeloma, acute intravascular hemolysis, leukemia,etc, there are still some protein leak out in the urine although the renal function is normal.
2. Infection of urinary system. On the one hand, the increase of inflammatory secretions in the urinary tract can increase the surface tension of liquid, on the other hand, some infections caused by bacteria also can lead to bubbles in the urine. Common urinary tract infections, including urinary tract infection, cystitis, prostatitis,etc., are mostly accompanied by urinary frequency, urgency, urine pain and other symptoms.
3. Diabetes increase. Diabetic patients tend to produce bubbles in the urine because the elevated blood sugar and the urine sugar accordingly. In addition, eating a lot of carbon hydrates or inject large number of glucose also can lead to bubbles emerge.
4. Some other rare causes. Other causes for bubble urine also include bladder colon fistula,etc., but is very rare, which need special inspection to make a definite diagnosis.
Above all, for the repetitive bubble urine, it is necessary to see doctor timely and figure out what cause it on earth.
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