（内科学ppt课件）02慢性肾小球肾炎.pptVIP

Chronic Glomerulonephritis;What is chronic glomerulonephritis (CGN)?;;gross hematuria;Why shall we learn CGN ?;Etiology and Pathogenesis;;pathology;Clinical manefestation;;hypertention;hypertention; female at the age of 31 impaired vision ophthalmologist →fundus hemorrage →hypertention(160/102mmHg) cardiologist →urine analysis kidney fuction ;hypertention;hypertention;hypertention;Clinical manefestation;Laboratory tests;diagnosis;Differential diagnosis;1.Lupus nephritis;What is SLE?;Manefestaion of SLE;Manefestaion of SLE;Manefestaion of SLE;;;Case report ;Case report;A long history of diabetes, then urinary abnormality. Evidence of other diabetic microvascular complications :such as diabetic retinal lesions or diabetic neuropathy. Glomerular hematuria is not obvious. ;DN（diabetic nephropathy);secondary to primary hypertention. history of primary hypertention more than 5- 10 years; renal tubular disfunction occurs earlier than glomerular injury; mild proteinuria; complicated with heart and brain injury;caused by allergic purpura high incidence in children. symmetrical purpura (the four limbs ) hematuria , different levels of proteinuria joint pain abdominal pain and bloody stool;Recurrent urinary tract infection history; Urine bacteriological examination often positive; Imageology examination : double kidney asymmetric shrink. ; 6. Alport syndrome positive family history ,more onset in adolescent ( 10 years old);Kidney damage (hematuria, mild-to-moderate proteinuria and progressive renal impairment) , deafness ,eyes impaired 7. other nephritis Asymptomatic hematuria or /and proteinuria Acute post- infection nephritis: A precursor infection then acute onset C3 dynamic change self-healing tendency ;treatment;;Diet therapy;Blood pressure control;;Other antihypertensive drugs: diuretics calcium channel blockers beta receptor blockers alpha receptor blockers Target blood pressure : 130/80 mmHg (proteinuria 1 g/d) 125/75mmHg(proteinuria 1 g/