Subscribe
165
Zhou Qi
Nephrology
About me
An associate chief physician in the Nephrology Department of the People's Hospital of Ma'anshan City, with a Master's degree from a key medical university. Participated or led multiple projects funded by the Natural Science Foundation, and published nearly ten papers in Chinese and core journals.
Proficient in diseases
Glomerular diseases, diabetic nephropathy, lupus nephritis, blood purification.
Voices
Principles of Acute Nephritis Treatment
The treatment of acute nephritis mainly involves managing the complications of acute nephritis, because acute nephritis itself can potentially heal automatically. The inflammatory reaction in the glomeruli can naturally subside, and proteinuria can decrease, kidney function can recover. However, acute nephritis may cause some complications that could be life-threatening to the patient. Therefore, treatment should focus on these complications to help the patient overcome difficulties, and then wait for the acute nephritis to heal automatically. Common complications mainly include heart failure, high blood pressure, pulmonary infections, etc. Thus, if a patient experiences heart failure, diuretics or even dialysis may be needed, and if an infection occurs, a full course of antibiotics is necessary for anti-inflammatory treatment.
Does diabetic nephropathy hurt?
Diabetic nephropathy generally does not cause painful symptoms. Diabetic nephropathy refers to the kidney damage that results from long-term diabetes, caused by factors such as hyperglycemia, oxidative stress, and an increase in advanced glycation end products. In the early stages, patients may experience an increase in kidney size and an increased glomerular filtration rate. As the condition progresses, proteinuria may occur, and it could eventually lead to severe renal failure. Throughout this process, patients typically do not experience pain because the kidneys do not have nerve innervation and therefore do not feel pain. Thus, including diabetic nephropathy, various kidney diseases and nephritis generally do not manifest with pain.
Does hydronephrosis cause pain?
Patients with hydronephrosis do not all experience pain. In fact, only a minority of patients experience pain. Hydronephrosis is caused by some form of urinary obstruction, such as urinary system stones, tumors, or problems like prostate enlargement, which prevent urine from being excreted smoothly. In this case, the accumulation of fluid can be a long-term, gradual buildup. Patients often adapt to the progression of the condition and do not exhibit obvious symptoms, especially in the early stages. However, some patients may experience pain, such as those with urinary system stones, or pain may occur when a tumor ruptures.
Is pyelonephritis easy to treat?
Most cases of pyelonephritis start acutely, with patients abruptly experiencing bacterial infections in their urinary system, causing inflammation in areas such as the renal pelvis and calyces. This manifests clinically with symptoms such as fever and back pain. This acute onset type is called acute pyelonephritis, and it is relatively easy to treat because it involves a bacterial infection that requires antibacterial treatment. Hence, it is generally manageable. However, if a patient's condition becomes prolonged and turns into chronic pyelonephritis, treatment may be more challenging. The bacteria causing chronic pyelonephritis are often drug-resistant, and this condition might be associated with predisposing factors for urinary infections, such as urinary system stones, anatomical abnormalities of the urinary tract, or obstructions that can conceal bacteria or contribute to their resistance, making treatment more difficult.
Is pyelonephritis more serious or nephritis more serious?
Pyelonephritis is an upper urinary tract infection caused by a bacterial infection, leading to an inflammatory response in the urinary system. The severity of this condition can vary. Nephritis, on the other hand, refers to the sterile inflammation within the glomeruli of the kidney, which also varies in severity. Therefore, it is challenging to compare these two diseases in terms of their severity. In the case of pyelonephritis, most conditions are relatively more treatable, and using antibiotics can control acute pyelonephritis. However, a small number of patients may develop severe complications such as perinephric abscess, acute renal failure, renal papillary necrosis, and even death from septic shock. The severity of nephritis also varies, with symptoms ranging from significant proteinuria to mild hematuria. Therefore, a comparison should be based on the specific conditions of the patients. (The use of medications should be under the guidance of a doctor.)
Is acute nephritis contagious?
Acute nephritis is not contagious. Although acute nephritis often follows a history of streptococcal infection, when such streptococci infect the human body, they can cause an immune complex reaction, which circulates through the bloodstream to the kidneys causing inflammation. Furthermore, these streptococci can have a cross-immune reaction with kidney tissue. These mechanisms together lead to diffuse proliferation of glomerular capillary cells, causing hematuria, proteinuria, and even renal failure. However, this condition generally is not contagious. Although this disease is related to streptococcal infection, these streptococci are mostly opportunistic pathogens and are unlikely to cause harm to people other than the patient, making it difficult to trigger a nephritis reaction again.
Causes of hematuria in IgA nephropathy
IGA nephropathy is a type of chronic glomerulonephritis. This disease often causes patients to have blood in their urine, and can also lead to visible blood in the urine. The glomerulus is a cluster of capillaries with semi-permeable functions, allowing water and metabolic waste to pass through while preventing proteins and red blood cells from passing. The waste and water pass through the glomerular filtration barrier and enter into the urine, which is the main component of urine. If some pathological cause damages the capillaries of the glomerulus, such as in the case of IGA nephropathy where there is an inflammatory response within the glomerulus, it can damage the glomerular filtration barrier. As a result, red blood cells may pass through the capillary walls of the glomerulus into the urine, causing blood in the urine.
Does acute nephritis easily lead to excessive internal heat?
What is referred to as "getting heated" generally refers to the appearance of herpes around the mouth. In fact, most people carry the herpes virus, which typically does not flare up under normal circumstances. However, when the body's immune system is weakened, the virus can become active. For example, factors like long-term fatigue, lack of sleep, or other illnesses can lead to the reemergence of these sores. They can also appear during acute nephritis, as this condition involves kidney abnormalities or possible symptoms like blood and protein in the urine. Some patients may also experience reduced urine output and acute kidney failure. During acute kidney failure, the immune system is often weakened, which can lead to the reappearance of herpes around the mouth, commonly known as "getting heated."
Is nephrotic syndrome contagious?
So, nephrotic syndrome is a general term for a group of clinical symptoms, a state of disease, and is not essentially an independent disease. Thus, this problem is not infectious. This disease describes the damage to the kidneys due to some reason, leading to the disruption of the integrity of the glomerular filtration barrier, resulting in the patient developing a significant amount of urinary protein. The disease itself is not contagious. However, there are very few cases of nephrotic syndrome that might be caused by hepatitis B virus infecting the kidneys. In such cases, the hepatitis B virus may have a certain level of contagiousness, but even so, it does not imply that nephrotic syndrome itself is contagious. In other words, even if such patients transmit hepatitis B to others, it does not necessarily mean those others will exhibit kidney damage.
How long does hematuria last in acute nephritis?
The condition of acute nephritis is generally quite severe. Patients may experience hematuria and proteinuria, with diffuse cellular proliferation in the glomeruli. However, this disease is self-limiting, and the condition can heal on its own. It is important to control the causes of acute nephritis and the complications it may cause to help patients overcome the difficulties. Afterward, the patients' hematuria and proteinuria could potentially disappear. Generally, it takes about 3 to 4 weeks for the urinalysis to turn negative, and some patients may even take up to six months to recover. If recovery takes more than six months, it is possible that the patient's acute nephritis has become chronic nephritis.