How to do glomerular nephritis:
(a) general treatment in patients with no obvious edema, and is not serious, no performance, can take care of life, even in minor work, but to prevent respiratory tract infection, avoid overworked, do not use toxic effects of drugs on the kidney. There is a clear high blood pressure, edema, or in the short term there is a decline in renal function, should be in bed rest, and limit the intake of salt to 2 ~ 3G. The more protein loss in the urine and kidney function is acceptable, should add high biological potency of animal protein, such as eggs, milk, fish and lean meat, pre-existing renal dysfunction (endogenous creatinine clearance at about 30ml / min), should be appropriate restrictions protein in around 30g, if necessary, add oral amount of essential amino acids.
(two) hormone and immunosuppressive agents. Due to the side effects of repeated and intense, more and more people on the rejection of drug treatment, need new method)
(three) treatment of nitrogen
1 in the short term, the emergence of nitrogen or the first time, or in the near future there is a progressive increase in bed rest, limit excessive activity.
2 diet and nutrition for no obvious edema and high blood pressure do not have to limit the water and sodium intake, the appropriate increase in water to increase urine volume is very important. In patients with mild to moderate degree of nitrogen, it is not restricted protein intake, in order to maintain a positive nitrogen balance in the body, especially the loss of protein in the daily quality of more patients should pay attention to. The increase of plant protein, such as soybean, can be increased in a large number of proteinuria with mild nitrogen. Severe n or the near future, the appropriate restriction of protein intake.
3. On urine volume and urine osmotic concentration of azotemia patients urine osmotic concentration often at or below the 400mosm/l. If the daily urine volume only 1L cannot discharge nitrogenous solutes and therefore should be required urine volume at 1.5L or above, appropriate drinking water or drink tea can achieve this purpose, when necessary can be interrupted by taking diuretics.
4 control of hypertension, chronic nephritis, chronic nephritis, nitrogen and renal parenchymal hypertension often suggest poor prognosis, persistent or severe renal hypertension and can increase the quality of nitrogen. In general, antihypertensive drugs can reduce the peripheral vascular resistance but do not necessarily reduce the glomerular vascular resistance.
Glomerular afferent and efferent arteriolar resistance enhancement reduced glomerular filtration function. Calcium channel blocking agent such as nifedipine can reduce intraglomerular pressure protection of renal function are still objections. It is now accepted vascular angiotensin converting enzyme inhibitors not only decrease peripheral vascular resistance, it can inhibit the tissue renin angiotensin angiotensin system, reduce the glomerular and efferent arteriole tension, improve intraglomerular hemodynamic change and ACEI is the degradation of bradykinin in tissue reduced and the bradykinin expansion effect is enhanced.
5 in the treatment of the treatment of chronic nephritis and edema in the treatment of chronic nephritis edema and edema in the regression phase GFR often have different degrees of reduction. Clinical in judging the reason often is not easy, except for the 1, 6 and 7 items shall be handled in a timely manner, other without infection, sometimes need to be patient to wait for, not an overly positive; acute interstitial nephritis merger, both the disease itself immune reaction, allergic reactions to drugs using short-range relatively large dose hormone often reduced azotemia should be processed in a timely manner.
6. Anticoagulation treatment in our hospital for treatment of various pathological types of glomerular nephritis with hypercoagulable state and renal fibrinoid necrosis with heparin 50 to 80mg / day and urokinase 2 ~ 8 million U / day by intravenous drip (2 ~ 8 weeks) of more than 400 cases, renal function often have different degrees of improvement, and no severe bleeding occurred in one case
