2014年9月4日星期四

Easily confused with acute nephritis disease

Early acute nephritis easily confused with the following diseases, should attract attention.
(1) febrile proteinuria can appear in any febrile illness. During the fever can be detected in urine protein and tube type, but very few red blood cells, and no edema and hypertension. Heat back, urinary abnormalities rapid recovery.
(2) infection of any cause abnormal urine infection, such as bacteria, viruses, especially during beta-hemolytic streptococcal infection, about one-third of patients may have mild microscopic hematuria, a small amount of urine protein and tube type, but no edema and hypertension, when the infection control, urinalysis returned to normal.
(3) focal glomerulonephritis generally occurs during infection (acute nephritis occurs about two weeks after infection); focal nephritis with hematuria, proteinuria is very light; infection cure, the patient urinalysis recovery normal, good prognosis. With only mild acute nephritis urine change without edema and hypertension similar.
(4) abnormal urine after exercise, vigorous exercise (such as running, swimming, rapid march ......) or excessive fatigue, abnormal urine can occur within hours - hematuria, proteinuria, as well as urinary tube, but rest 1-2 days (no later than 7 days) returned to normal. In the event of abnormal urine while no edema and hypertension (high blood pressure individuals may have temporarily).
(5) lupus nephritis kidney damage caused by systemic lupus erythematosus, sometimes expressed similar to acute nephritis, often accompanied by a rash, alopecia, photosensitivity, joint pain and heart, liver, lung, brain and other organs of the disease, and more than a fever, leukopenia, laboratory SM antibody or anti-DNA antibodies and antinuclear antibodies.
(6) toxemia of pregnancy occurred in late pregnancy, patients with edema, hypertension, proteinuria and tubular urine, severe hypertensive encephalopathy can occur, especially during the last months of pregnancy symptoms more pronounced. But the lack of hematuria is its main feature, and most normal renal function, fundus visible retinal artery spasm, bleeding, oozing and other changes, most patients return to normal after childbirth.
(7) primary nephrotic syndrome associated with acute nephritis, nephrotic syndrome and kidney disease are easy to confuse. The latter with heavy proteinuria (≥3.5 g / day) and is characterized by hypoproteinemia, no hematuria, former hematuria, no more hypoalbuminemia, identify points of renal pathology examination, the former diffuse capillary proliferative glomerulonephritis, which can form tiny lesions or other pathological changes of chronic glomerular damage.

(8) acute pyelonephritis acute nephritis if the urethra, bladder mucosa and kidney congestion and edema can cause bladder irritation, similar acute pyelonephritis occur. But pyelonephritis fever, hematuria, leukocytes were increased urine bacterial culture positive, antibiotic treatment is effective, and no edema, hypertension and other symptoms, and no red blood cells in urine tube.
Acute pyelonephritis is still easy with acute exacerbation of chronic nephritis confused.

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