肾小球疾病总论英文.ppt

diagnosis Acute onset Rapidly progressive Renal failure within a few weeks to a few months Acute renal failure-chronic renal failure Treatment-early!!! Aim to humoral immune mechanism Plasmapheresis discard the antibodies plasm exchange immoadsorption,type1 typ2 Drugs:glucocorticoid+cytotoxic drugs MP05.-1.0g/d,repeat if necessary CTX type2-type3 Symptomatic treatment Renal failure Balance of fluid,electrolytes and acid base Dialysis Infection hypertension prognosis Hardly relieve Mostly CRF-death Risk factors:type1 worst,type2 worse,type 3 bad Treatment:not progressive,not prompt Age:the aged Chronic glomerulonephritis Clinical manifestation:chronic nephritis syndrome Pathological change:except MCD,MmRPN,crescentic GN Clinical manifestation Age:any age,frequently young Priliminary infection:upper respiratory infection,intestinal tract,latent period1w Nephritis syndrome: Hematuria,proteinuria,edema hypertention,Renal failure uremia Prognosis factor Pathological properties Treatment Hypertension Infection,prerenal factors(hypertension etc) Nephrotoxic drugs Point of diagnosis Chronic onset proteinuria and/or hematuria Protracted and progressive AGN CGN age children Young/middle-aged Preliminary infection frequently sometimes Latent period 1-3w 1w onset acute Chronic,insidious hematuria 100% Sometimes no edema frequently Sometimes no hypertension frequently Sometimes no ASO frequently↑ normal Blood C3 ↓,8W persistent↓/normal prognosis 1y protracted and progressive Secondary GN SLE:sysmetic presentation Immune abnormality Pathological changes Treatment Target Inhibit immune reaction Halt the progression of disease Restrictive intake of protein 0.5-0.8g/kg/d Protein of high biological value ↓Pressure in glomeruli antihypertention Less than 140/90mmHg Ideal target125/83mmH