Hidden nephritis

　　The causes of hidden nephritis may be various, including infections by streptococcus and other bacteria, viruses, protozoa, and so on. Pathological changes can show a wide variety of pathological types, including minimal change disease, mesangial proliferative glomerulonephritis (including IgA nephritis), focal segmental proliferative glomerulonephritis, and sometimes similar to the nephritis after streptococcal infection in the resolution phase. In a few cases, it can present with relatively severe glomerular lesions. In addition, hereditary nephritis can also start with asymptomatic hematuria and/or proteinuria, so a renal biopsy is needed to clarify the etiology.

　　1. Respiratory tract diseases

　　Generally, within 1-2 weeks after the onset of hidden nephritis, patients may suddenly develop respiratory diseases, such as colds, pharyngitis, tonsillitis, cough, and other symptoms.

　　2. Edema or swelling of the skin

　　The majority of asymptomatic nephritis patients will show systemic skin edema. Especially in the morning after waking up, the eyelids, cheeks, and neck of asymptomatic nephritis patients will have obvious swelling, which has a watery sensation when pressed with hands.

　　3. Systemic abnormal manifestations

　　Starting from the third week after the onset of asymptomatic nephritis, significant anorexia may occur, especially in the form of dizziness, fatigue, low back pain, weakness of hands and feet, aversion to cold, and nausea during the day. For the elderly, severe hypertension and convulsions may also occur.

　　Most patients with asymptomatic nephritis have no obvious symptoms and signs, and only some patients may have atypical manifestations such as low back pain, fatigue, and gross hematuria. The main clinical features are abnormal urine, which can manifest in three forms:

　　1. Persistent mild to moderate proteinuria, urine protein + ~ ++, 24h urine protein quantification less than 1g, and there may be granular casts in the urine sediment, and there may be a small amount of red blood cells <5/HP>. The pathological changes are mostly mild mesangial proliferation or focal mesangial proliferative.

　　2. Persistent or intermittent hematuria is the main symptom, and the differential microscopic examination of urine red blood cells shows mainly deformation. It often appears under the influence of triggers such as fever, pharyngitis, overwork, catching a cold, and drug injury, and transient macroscopic focal hyperplasia may occur.

　　3. Persistent proteinuria and hematuria, and sometimes edema, increased blood pressure, and other symptoms may occur. However, after the trigger has passed, they can return to the original asymptomatic state. This type of patient has a poorer prognosis and is prone to slowly develop into renal insufficiency. The pathological changes are the early stage of obvious mesangial cell proliferation, membranous proliferative, membranous nephritis, and focal sclerosis nephritis.

　　1. Do not take medication blindly when feeling uncomfortable. It is necessary to go to the hospital for examination in time, and medication should follow the doctor's instructions. Many drugs contain toxicity that can cause kidney damage.

　　2. Diet should be light, not too salty, and do not consume too much protein. Excessive salt and protein consumption is not good for our health. Do not overeat, as it can easily increase the burden on the kidneys and may lead to asymptomatic nephritis.

　　3. Prevent and control hypertension and hyperglycemia. Long-term hypertension and hyperglycemia are very likely to cause renal damage, leading to the occurrence of asymptomatic nephritis. Therefore, patients with diabetes and hypertension should pay special attention, strictly control the condition, and prevent the occurrence of nephritis.

　　4. Abandon bad habits such as staying up late, holding urine, and overeating, and have regular health checks. Early detection and early treatment of asymptomatic nephritis are very important.

　　The diagnosis of this disease is relatively difficult. It should be made through long-term observation and detailed examination. Only after finding persistent urinary changes or recurrent hematuria and excluding other diseases can a clinical diagnosis be made. The key points are as follows:

      1. Intermittent or persistent microscopic hematuria;

　　2. There may be mild proteinuria, and the quantitative analysis of urine protein

　　3. Symptoms and signs are not prominent, and renal function is normal;

　　4. The course of the disease is long, but the prognosis of most patients is good. In addition to the above examinations, if it is possible to perform renal biopsy early, it is not only an important method for clarifying the diagnosis, but also can determine the pathological type and prognosis.

　　Dietary adjustment is very helpful for the treatment of hidden nephritis, and a reasonable diet can not only improve various discomfort symptoms caused by hidden nephritis but also fundamentally eliminate any factors that may increase the burden on the kidneys. Therefore, the dietary principles for patients with hidden nephritis can be followed by the following methods:

　　1. According to the patient's condition, appropriate protein supplementation should be provided. If the patient's renal function is weak, then the intake of protein should be reduced, such as reducing the supply of eggs and milk.

　　2. It is best to provide three meals a day mainly with liquid foods, which can be replaced by lotus starch, wheat starch, corn starch, etc. in place of rice. Until the patient's symptoms improve, the use of liquid foods can reduce the burden on the kidneys.

　　3. Ensure the provision of sufficient calories, especially carbohydrates and a small amount of fat, which should be provided in small amounts.

　　4. Clean and hygienic food is very important, and the salt content in the food should be minimal, with no more than 2.5 grams per day as a good choice.

　　5. Provide adequate amounts of vitamin A, B, and C, and it is recommended that patients eat more fresh fruits and vegetables.

　　Use an appropriate amount of diureticsPatients with hidden nephritis have excessive uric acid in their bodies. Helping patients urinate can reduce the burden on the kidneys. At present, diuretics commonly used in medicine are Furosemide, butamide, etc. When using these drugs, it is recommended to use a small dose of dopamine to relieve kidney stress and help treat hidden nephritis.

　　Maintain blood pressure stabilityMost patients with hidden nephritis have high blood pressure, and lowering and controlling blood pressure is very important for the treatment of hidden nephritis. Common antihypertensive drugs include phentolamine,络活喜, sodium nitroprusside, etc., which are administered intravenously and can effectively control blood pressure, prevent cardiovascular diseases caused by hypertension.

　　Reduce the potassium content in the bloodIn the food given to patients with hidden nephritis, the potassium content should be reduced as much as possible. Glucose or insulin can be given during the regular treatment process. If the hidden nephritis shows an increase in blood potassium levels, hemodialysis should be used for treatment.