How much do you know about chronic nephritis, the silent health killer?

What is chronic nephritis?

In the outpatient clinic, we often hear, "Doctor, I have back pain, is it nephritis?"

"Doctor, I have night sweats, is it nephritis?" "Doctor, my eyes are swollen, is it nephritis?"

…

As doctors, we will smile. Why? Let me tell you what chronic nephritis is.

Chronic glomerulonephritis is abbreviated as chronic nephritis. The disease has an insidious onset and there are no obvious symptoms and signs at first. Occasionally there are symptoms such as fatigue, tiredness, and poor appetite, which are often easily ignored by patients.

Urine is a mirror of the kidneys, and kidney diseases often cause changes in urine first. Therefore, many patients go to the hospital for treatment when they find that their urine foam increases or the color of urine becomes darker, or even when they have visible hematuria. More patients learn that they have chronic nephritis when they find protein and/or red blood cells in their urine during a urine test for physical examination or other reasons.

At the same time, due to the protracted course of the disease and the slow progression of the disease, coupled with the general public's lack of knowledge about chronic kidney disease, some patients are not diagnosed until they reach the end-stage renal disease (ESRD) stage and develop obvious symptoms of uremia, such as gastrointestinal symptoms such as nausea and vomiting, and heart failure symptoms such as chest tightness and shortness of breath.

Onset of chronic glomerulonephritis

Chronic glomerulonephritis can occur at any age, but it mainly affects young and middle-aged men. The onset and clinical manifestations are diverse. There are three common onsets:

01: Insidious onset

There are no obvious clinical symptoms, occasionally mild edema, and the disease is usually discovered through physical examination.

02: Chronic onset

Patients may experience fatigue, tiredness, poor appetite, eyelid and/or lower limb edema, accompanied by varying degrees of hematuria and/or proteinuria. Some patients may also have hypertension as a prominent symptom.

03: Acute onset

Some patients experience acute attacks due to fatigue, infection, increased blood pressure, diarrhea or use of nephrotoxic drugs, which causes their condition to deteriorate rapidly.

In your daily life, have you noticed or noticed similar symptoms? Do you take them seriously? Have you delayed diagnosis and treatment due to neglect? ... Therefore, we repeatedly emphasize the importance of self-care and regular physical examinations.

The most common pathological type of chronic glomerulonephritis

The pathological types of chronic glomerulonephritis are diverse, and may manifest as diffuse or focal segmental mesangial proliferation, membranous proliferation, membranous, minimal lesions, focal sclerosis, etc., and may be accompanied by varying degrees of renal interstitial tubular inflammation and fibrosis.

Among them, mesangial proliferative glomerulonephritis dominated by immunoglobulin A (IgA) or IgA deposition in the glomerular mesangium, namely IgA nephropathy, is the most common. At present, this disease is also the most common primary chronic glomerular disease in my country and even in the world, and is one of the main causes of ESRD. 25% to 30% of patients progress to ESRD within 20 to 25 years after the onset of clinical symptoms. The incidence of IgA nephropathy varies from place to place, and there are obvious regional differences. The incidence of IgA nephropathy in my country is 30% to 40%.