Additional methods of examination

Clinical blood analysis: leukocytosis and increase of accelerated ESR.

Clinical urine analysis: in macroscopic study - urine is "meat wastes" color, cloudiness, without odor, olyguria, low specific gravity and moderate or significant proteinuria: in microscopic study observed large amount of altered erythrocytes (hematuria), cylinders (hyaline, erythrocytes and waxy casts) and leucocytes (non-constant).

Zimnitsky's test: izostenuria.

Nechiporenko's method: prevalence of erythrocytes under leucocytes; casts more 250 in ml.

Biochemistry of the blood: hypoproteinemia (hypoalbuminemia) and dysproteinemia.

Electrocardiography reveals signs of hypertrophy and overload of the left-ventricular myocardium. The amplitude of ECG waves decreases.

Renal biopsy: use for differential diagnosis and determination of the glomerulonephritis cause.

Chronic glomerulonephritis (nephritic form)

Chronic glomerulonephritis (nephritic form) is the variant of glomerulus's injury that characterized by the prevalence in clinic of nephritic syndrome signs.

Clinical features

The clinical features more frequently develop gradually accordantly to the proteinuria level.

The main complaint in patients with nephritic syndrome is edema that initially arises on the face and in disease progression spreads from the face downward up t hydrothorax, hydropericardium and anasarca.

Objective examination: General patient's condition is from moderate grave 1 extremely grave. In general examination is detected "fades nephritica " - the face is edematous and often pale. Swelling usually appears first around the eyes in the morning and eyes may become slit like when edema is pronounced.

The color of the skin characterized by pathological pale, observed decreased turgor and elasticity of the skin, scars on the abdomen and hips due to the over stretching of the skin.

Edema in patients with nephritic syndrome (edema renalis) characterized by symmetrical localization, in initial stages arises on the face in the morning, has descending character and spreads on extremities, loin region with next fluid accumulation in cavities (hydrothorax, hydropericardium and anasarca). The skin over edema is glossy.

In heart auscultation detects decreased loudness of the heart sounds. The data of percussion and renal palpation aren't specific.

Complications: renal failure, heart failure, encephalopathy, stroke, eclampsia.

Outcomes of disease: fast progression with poor prognosis, renal failure and death.

Additional methods of examination

Clinical blood analysis: leukocytosis and increase of accelerated ESR, anemia.

Clinical urine analysis: in macroscopic study - urine is "meat wastes" color, cloudiness, without odor, olyguria, low specific gravity and significant proteinuria: in microscopic study observed large amount of altered erythrocytes (hematuria), cylinders (hyaline, erythrocytes and waxy casts) and leucocytes (non-constant).

Zimnitsky's test: olyguria, nocturia, izostenuria.

Nechiporenko's method: prevalence of erythrocytes under leucocytes; casts more 250 in ml.

Biochemical blood analysis: increase of creatinin, ammonium and urine acid levels, hypoproteinemia (hypoalbuminemia) and dysproteinemia, increased potassium, magnum, sulphatis and phosphates level with sodium, calcium, chloral and hydrocarbonatis concentration is decreased. Decrease of Glomerulus's filtration rate.

Renal biopsy: use for differential diagnosis and determination of the glomerulonephritis origin.

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