Glomerulonephritis - group of inflammatory diseases with a primary lesion of renal glomuluses, and also with involving canaliculuses and an interstitial (intersticial) tissue. Proceeds in the form of acute or chronic process with repeated exacerbations and remissions. In more rare cases quickly progressing (subacute) glomerulonephritis for which the rough progressing current quickly leading a renal failure is characteristic is observed. The acute glomerulonephritis can develop at any age, however the majority of patients is made by children (since 2летнего age) and adults till 40 years.

Signs, current. The acute glomerulonephritis is characterized by three basic signs - hydropic, hypertonic and urinary. In a clinical picture of an acute glomerulonephritis edemas which serve as a precursory symptom of disease at 70-90 % of patients have Great value; they settle down mainly on the face and together with paleness of a skin frame characteristic « the face of the patient ». Often the liquid collects in cavities (pleural, abdominal, cavities of a pericardium). The increase of mass of a body for short time can reach 15-20 kg and more, but in 2-3 weeks. Edemas usually disappear. One of cardinal signs of an acute diffusive glomerulonephritis is the arterial hypertensia observed at 60-70 % of patients. In most cases the BP does not reach high value (160/100 mm hg) . At children and teenagers rising of a BP happens less often, than at adults. Was acutely the arisen arterial hypertensia can lead to development of an acute heart failure, especially left stomach. Later the hypertrophy of a left ventricle of heart is possible. At inspection expansion of borders of intimate dullness that can be caused by accumulation of a transudate in a cavity of a pericardium and expansion of cavities of heart owing to an acute hypervolemia is defined. Are quite often auscultated functional systolic hum on an apex, accent of II tone on an aorta, sometimes a cantering rhythm: in lungs - dry and wet rhonchuses. The arterial hypertensia at an acute glomerulonephritis can be accompanied by development of an eclampsia, but the uremia thus is not present. An eclampsia to consider as an acute encephalopathy as it is caused by an arterial hypertensia and edemas (a hypervolemic wet brain) more correctly. Despite of a serious clinical picture of eclamptic attacks (tonic and clonic cramps, stings of tongue), they seldom come to an end mors and pass mostly completely. In urine fiber and erythrocytes are found out mainly. The quantity of fiber in urine usually changes from 1 up to 10 g/l, but 20 g/l and more quite often reach. The high maintenance of fiber in urine is marked only in the first 7-10 days, therefore at late research wet a proteinuria it appears low (less than 1 g/l) is more often. The small proteinuria in some cases can be from the very beginning of illness, and during some periods it even can be absent. Small amounts of fiber in urine at the patients who have transferred an acute nephritis, are observed longly and disappear only in 36 months from the beginning of disease. The acute glomerulonephritis can be accompanied by a nephrotic syndrome. A hematuria - an obligatory and constant attribute of an acute glomerulonephritis; In 1315 % of cases there is a gross hematuria, in other cases - a microhematuria, the quantity of erythrocytes can sometimes not exceed 10-15 in sight. A cylindruria - not an obligatory sign of an acute glomerulonephritis. In 75 % of cases find individual hyaline and granular cylinders, sometimes there are epithelial cylinders. The leukocyturia, as a rule, happens insignificant, however sometimes find out 20-30 leucocytes and more in sight. At many patients within first several days of disease the insignificant or moderate azotemia is marked. Often at an acute glomerulonephritis the haemoglobin content and number of erythrocytes in a peripheric blood decrease. It is bound to a hydremia (the raised maintenance of water in a blood), and also can be caused by a true anemia as a result of influence of the infection led development of a glomerulonephritis (for example, at an infectious endocarditis). It is often defined raised by an ESR. Quantity of leucocytes in a blood, as well as temperature reaction, are defined by an initial or accompanying infection (more often the temperature normal also is not present a leukocytosis). Distinguish three most typical variants of current of an acute glomerulonephritis. The cyclic variant is characterized by the rough beginning. There are edemas, a dyspnea, a headache, a pain in lumbar area, the quantity decreases wet. In analyses of urine - high value of a proteinuria and a hematuria (urine in the form of « meat slops »). Rising of a BP is usually accompanied by a bradycardia and a sinus arrhythmia, can become complicated development of an eclampsia and a heart failure (an intimate asthma, a fluid lungs). Edemas keep 2-3 weeks. Then in disease there comes fracture: the polyuria develops and the BP decreases. The period of convalescence can be accompanied by a hyposthenuria. However it is frequent at good state of health of patients and practically full restoration of working capacity can it is long, months to be observed the small proteinuria (0,03-0,1 g/l) and a residual hematuria. The latent variant meets quite often, and its diagnostics is of great importance, as becomes frequent at this form disease chronic. This form of a glomerulonephritis is characterized by the gradual beginning without any expressed subjective signs and shown by only small dyspnea or edemas on legs. In such cases the glomerulonephritis manages to be diagnosed only at regular research of urine. The tightened variant, as a rule, has not infectious parentage. It is characterized by the gradual beginning with an accrueing proteinuria and a nephrotic syndrome, the hypertensia and a hematuria are not expressed. The appreciable proteinuria is kept within 1-1,5 months and more. Any acute glomerulonephritis which has not ended completely within year, it is necessary to consider passed in chronic. In some cases it is is acute the begun diffusive glomerulonephritis can accept character fast progressing.