Chronic glomerulonephritis (hypertensive form)

Chronic glomerulonephritis (hypertensive form) is the variant of glomerulus's injury that characterized by the stable blood pressure increase.

Clinical features

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

The main complaint in patients are headache, lost of vision, dizziness, lost of sleeping and edema that initially arises on the face and in disease progression spreads from the face downward up to hydrothorax, hydropericardium and anasarca.

Objective examination: General patient^'s condition is from moderate grave to extremely grave. In general examination detects "faces nephritica ", pale color of the skin and visible mucus, edema renalis.

In heart percussion detect displacement of the left heart border outward and downward.

In heart palpation - apex beat displaced outward and downward, diffuse, high and strong strength.

In heart auscultation detects decreased loudness of the heart sounds, accentuated II heart sound over aortic valve. Stable blood pressure increases (with high diastolic blood pressure level).

Complications: edema of the brain, edema of the retina, myocardial infarction, cardiac asthma, encephalopathy and chronic renal failure.

Additional methods of examination

Clinical blood analysis: without significant changes.

Clinical urine analysis: decrease of specific gravity, proteinuria; in microscopic study cylinderuria, microhematuria.

Zimnitsky's test: olyguria, nocturia, izostenuria.

Biochemical blood analysis: increase of creatinin, ammonium and urine acid levels, decrease of Glomerulus's filtration speed, non-constant - hypoproteinemia and dysproteinemia.

ECG: the signs of left ventricle hypertrophy and systolic overload.

In ophthalmoscope examination: the signs of renal retinopathy- edema of the retina, spasm of the arteries, dilation of the veins, hemorrhages.

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

Chronic glomerulonephritis (mixed form).

Chronic glomerulonephritis (mixed form) is the variant of glomerulus's injury that characterized by the presence of hypertensive and nephritic syndromes.

Clinical features

The clinical features more frequently develop gradually accordantly to the proteinuria level. The main complaint in patients is edema that initially arises on the face and in disease progression spreads from the face downward up to hydrothorax, hydropericardium and anasarca.

Also may be present general weakness, thirst, and loss of appetite, headache, vision changes and dizziness.

Objective examination: General patient’s condition is from moderate grave to extremely grave. In general examination detects "faces nephritica" and edema renalis with next fluid accumulation in cavities.

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. The skin over edema is glossy.

In objective examination detect displacement of the left border of the heart to the left, tachycardia, decrease loudness of the heart sounds and stable secondary arterial hypertension.

Complications: cardiac asthma, pulmonary edema, stroke, shock and chronic renal failure