Hepatogenic renal damage
Introduction
Introduction to liver-induced renal damage Hepatic-induced renal damage mainly includes glomerulonephritis caused by hepatitis B virus; 2 glomerulonephritis mainly caused by IgA nephropathy caused by immune, physiological and metabolic disorders in liver cirrhosis; 3 severe liver function Incomplete time, functional acute renal failure caused by hypoperfusion of the kidney, that is, hepatorenal syndrome. basic knowledge The proportion of illness: 0.002% Susceptible people: people with liver disease Mode of infection: non-infectious Complications: hepatic encephalopathy coma hypotension
Cause
Causes of hepatogenic renal damage
The causes of this disease are:
1 glomerulonephritis caused by hepatitis B virus;
2 glomerulonephritis mainly caused by IgA nephropathy caused by immune, physiological and metabolic disorders in liver cirrhosis;
3 severe liver dysfunction, functional acute renal failure caused by hypoperfusion of the kidney, namely liver and kidney syndrome.
Prevention
Hepatic kidney damage prevention
Actively treat various liver diseases and prevent disease changes.
Complication
Hepatic kidney damage complications Complications, hepatic encephalopathy, coma, hypotension
Can be complicated by hepatic encephalopathy, coma, infection, bleeding, hypotension and liver failure.
Symptom
Hepatic-induced renal damage symptoms Common symptoms Hepatic insufficiency Proteinuria Liver failure Yellow sputum Liver palm spider snoring Nausea hypotension Ascites hypertension
History and symptoms
(1) Hepatitis B virus-associated nephritis is more common in children and men, patients with hepatitis B or hepatitis B virus, clinical manifestations of asymptomatic proteinuria or nephrotic syndrome, a small number of patients may have gross hematuria.
(B) cirrhosis glomerulonephritis has a history of cirrhosis, patients may be characterized by abnormal urine test (such as microscopic hematuria), hypertension and renal insufficiency, etc., a small number of patients without clinical manifestations, renal function deterioration is slow.
(3) Hepatorenal syndrome is common in decompensated liver dysfunction. Most patients have certain incentives, such as excessive diuresis, massive ascites, gastrointestinal bleeding and application of certain nephrotoxic drugs; usually severely impaired liver function. Simultaneous or later oliguria, progressive deterioration of renal function within a few days, weeks or months, often accompanied by nausea, vomiting, mental apathy and lethargy; severe cases of hepatic encephalopathy and coma, infection, bleeding, low Blood pressure and liver failure are the main causes of death.
Examine
Hepatic kidney damage examination
(1) Serum HBV antigen is positive, and HBV antigen positive in kidney section is evidence for diagnosis of hepatitis B virus-associated nephritis.
(B) cirrhotic glomerulonephritis, urine changes with proliferative lesions aggravated proteinuria, tubular urine and microscopic hematuria became obvious, but gross hematuria is less common than primary IgA nephropathy, most patients with blood circulation immune complex Positive, blood immunoglobulin increased, IgA increased especially prominent, a small number of patients with blood C3 decreased.
(3) Patients with hepatorenal syndrome have negative or trace urine protein, normal urine sediment or a small amount of red, white blood cells and casts; thrombocytopenia, anemia and abnormal liver function; Ccr decreased significantly, blood urea nitrogen and creatinine increased.
(D) B-ultrasound can have changes in cirrhosis, but there is no change in the kidneys.
Diagnosis
Diagnosis and differentiation of hepatogenic renal damage
(1) Hepatitis B-associated nephritis needs to be differentiated from secondary glomerular diseases such as hepatitis B virus carriers and primary glomerulonephritis and lupus nephritis.
(B) renal dysfunction in the late stage of liver disease, should be differentiated from simple pre-renal azotemia, acute tubular necrosis, acute allergic interstitial nephritis.
