IgA nephropathy is a group of multiple causes of chronic glomerular disease with the same immunopathological features. Clinical about 40% ~ 45% of the patients showed gross or microscopic hematuria, 35% ~ 40% of patients showed microscopic hematuria with proteinuria, the rest showed nephrotic syndrome and renal failure. ...
IgA nephropathy is a group of multiple causes of chronic glomerular disease with the same immunopathological features. Clinical about 40% ~ 45% of the patients showed gross or microscopic hematuria, 35% ~ 40% of patients showed microscopic hematuria with proteinuria, the rest showed nephrotic syndrome and renal failure. IgA nephropathy is a common worldwide glomerular disease, and the prevalence of IgA nephropathy varies widely in different continents, in different countries or in different regions of a country, such as Asia, Japan, Singapore, IgA nephropathy 50% of primary glomerular disease, while the western United States only 2% of the Indian low incidence area. In general, white, yellow was significantly higher than the incidence of blacks. The incidence of IgA nephropathy in China accounted for 26% of primary glomerular disease ~ 34%. The ratio of male to female is about 2: 1. Hematuria-based IgA nephropathy is currently no special treatment. Due to the pathological type of IgA nephropathy and the degree of glomerular damage is greater. Therefore, patients should be closely observed the frequency of nausea hematuria, the degree of proteinuria, with or without hypertension and renal damage, and were to take appropriate control measures.
Clinically according to the different pathogenesis of renal edema is divided into two categories:
1, nephritis edema: mainly seen in acute nephritis, or part of the rapid nephritis, chronic nephritis and other glomerular diseases. Edema is mainly due to:
① glomerular filtration rate decreased, renal exclusion of water, sodium and edema occurred;
② ball - tube imbalance: glomerular acute inflammation, glomerular filtration rate was significantly reduced, but the renal tubular reabsorption is relatively good, so that the ball - tube between the loss of balance, sodium, water in the renal tubular reabsorption relative Increased edema;
③ capillary hydrostatic pressure increased, so that the capillary fluid too much to move into the tissue gap caused by edema;
④ acute nephritis, some patients due to increased blood volume, hypertension and other causes of congestive heart failure, increased water, sodium retention.
2, nephrotic edema: usually occurs in primary glomerulonephritis and other causes of nephrotic syndrome. The mechanism of its edema is mainly:
① plasma colloid osmotic pressure reduction: a large number of urinary protein protein caused by hypoproteinemia, resulting in decreased plasma colloid osmotic pressure, the capillary fluid filtration increased, from the tissue to recover the body fluid significantly reduced, and ultimately the formation of edema.
② effective blood volume reduction: the extravasation of plasma to reduce the amount of effective blood volume, stimulate the volume of blood vessels receptors, activation of renin - angiotensin - aldosterone system, increased antidiuretic hormone secretion, reduced secretion of sodium hormone, renal tubular reabsorption of sodium Increase, further aggravate the water, sodium retention, causing edema increased.
IgA nephropathy to hematuria as the main clinical manifestations and identification indicators, proteinuria is IgA nephropathy secondary identification indicators. However, once the body appears proteinuria, then the body of the water can not be well inhaled into the blood vessels, there will be water to the organization between the infiltration of the situation, this time, the patient will appear facial swelling or lower extremity edema, Mainly in the face of edema and lower extremity edema mainly. For patients who have been diagnosed with IgA nephropathy, edema is a manifestation of glomerular and renal tubular dysfunction.
IgA nephrotic treatment is focused on the protection of renal function, reduce proteinuria, control of hypertension, delay the progress of IgA nephropathy. Common drugs for the treatment of IgA nephropathy include angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor antagonists (ARB), hormones, immunosuppressive agents, anticoagulant, antiplatelet aggregation and fibrinolysis, fish oil, etc. , In addition to treatment iga kidney disease many people often use the method for tonsil removal and traditional Chinese medicine. The use of traditional Chinese medicine treatment of IGA nephropathy has certain advantages, it is through the syndrome differentiation to repair renal tissue, improve renal function, so that IgA nephropathy control. But to get a good effect, take some time. Because a few years or even ten years of chronic disease, it is impossible to cure overnight. Therefore, to remind patients with IgA nephropathy and patients, it is necessary to attach great importance to IgA nephropathy, active treatment, and not too impatient, to be patient treatment, until the complete recovery.
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