急诊科急性肾小球肾炎的处理综述

Bedor Alotaiby, Nesreen Faiz Falemban
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引用次数: 0

摘要

“肾小球肾炎”一词是指一组肾脏疾病,其特征是免疫介导的基底膜、系膜或毛细血管内皮的破坏,导致血尿、蛋白尿和氮血症。肾小球疾病的急性肾损伤发作通常由快速进展的肾小球肾炎(RPGN)引起。急性肾小球肾炎是由多种感染因子(如病毒、细菌或原生动物)以及非感染性原因(如过敏性紫癜(HSP))引起的免疫介导损伤引起的。最常见的感染原因是链球菌感染后肾小球肾炎(PSGN)。急诊医生必须进行彻底的体格检查,并获得完整的病史,包括草药、运动补充剂、非甾体抗炎药(NSAIDs)、血管紧张素转换酶(ACE)抑制剂、血管紧张素II受体阻阻剂(ARBs)和钙调磷酸酶抑制剂等药物。此外,必须正确监测患者的血压、体重、水合状态、水肿、皮肤表现、肺部和心脏检查。由于肾脏疾病没有特别的药物治疗,急性链球菌后肾小球肾炎(PSGN)的治疗大多是支持性的。当急性肾小球肾炎(GN)伴有慢性感染时,必须解决潜在的感染。重症监护病房的专业知识可能需要治疗高血压脑病或肺水肿的个体。肾病专家会诊可能是必要的。肾功能、血压、水肿、血清白蛋白和尿蛋白排泄率均应在门诊进行评估。在本文中,我们将回顾急性肾小球肾炎,其评估和管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Overview on Management of Acute Glomerulonephritis in the ED
The word "glomerulonephritis" refers to a group of kidney illnesses marked by immune-mediated destruction to the basement membrane, mesangium, or capillary endothelium, resulting in hematuria, proteinuria, and azotemia. Acute Kidney Injury episodes in glomerular disease are typically caused by rapidly progressive glomerulonephritis (RPGN). acute glomerulonephritis is caused by immunologically mediated damage caused by numerous infectious agents such as viruses, bacteria, or protozoa, as well as non-infectious causes such as Henoch–Schonlein purpura (HSP). The most prevalent infectious cause is post-streptococcal glomerulonephritis (PSGN). The emergency physician must conduct a thorough physical examination and obtain a complete medical history, including herbal agents, sports supplements, non-steroidal anti-inflammatory drugs (NSAIDs), angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), and calcineurin inhibitors, among other medications. In addition, the patient's blood pressure, weight, hydration status, edoema, skin manifestations, pulmonary and cardiac examinations must all be correctly monitored. Because there is no particular medication for renal illness, the treatment for acute poststreptococcal glomerulonephritis (PSGN) is mostly supportive. The underlying infections must be addressed when acute glomerulonephritis (GN) is accompanied with chronic infections. The critical care unit's expertise may be required for the treatment of individuals with hypertensive encephalopathy or pulmonary edoema. A nephrologist's consultation may be necessary. Renal function, blood pressure, edoema, serum albumin, and urine protein excretion rate should all be evaluated on an outpatient basis. In this article, we will be reviewing Acute glomerulonephritis, its evaluation as well as management.
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