慢性肾小球肾炎-english教学课件.ppt

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 3.Benign arteriolar nephrosclerosis 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 4. Purpura nephritis Recurrent urinary tract infection history; Urine bacteriological examination often positive; Imageology examination : double kidney asymmetric shrink. 5. Chronic pyelonephritis 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 Symptomatic treatment Diet therapy Water intake restriction when edema Low salt diet when hypertention Low protein diet when renal insufficent Blood pressure control Systemic hypertension and high pressure in glomeruli are important risk factors accelerating the progress of kidney disease Drugs : ACEI(angiotensin converting enzyme inhibitor) ARB(angiotensin receptor blocker) reduce the renal capillary pressure decrease proteinuria protect renal fuction 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/d) Symptomatic treatment control infection eliminate edema decrease proteinuria:glucocorticoid and immunosuppressive agent Avoid aggravating factors: keep away from infection,ren