Glomerulonephritis is not an independent nephritis disease, but a kind of
nephritis syndrome with impaired glomerulus and the same or similar clinical
manifestations. Clinically, Glomerulonephritis has the following
manifestations:
1. Renal Edema
Glomerulonephritis can cause edema which is related to the following three
aspects:
① The allergic reactions will increase systemic capillary permeability and
result in slight edema, which commonly occurs in Endocapillary Proliferative
Glomerulonephritis (EPGN).
② Oliguria and anuria cause the retention of water and sodium in the body,
which always presents in EPGN, Crescentic Glomerulonephritis and Scleroid
Glomerulonephritis, etc.
③ Due to the massive proteinuria and Hypoproteinemia, blood colloid osmotic
pressure declines and severe edema occurs, which can always be seen in Minimal
Glomerulonephritis, Membranous Glomerulonephritis (MGN), Membrano-Proliferative
Glomerulonephritis (MPGN), etc.
2. Cylindruria
The foreign cylinder which concentrates and deposits in renal tubules is
called urinary cylinder. It concludes glairy cast, cellular cast and granular
cast. If there are casts in urine, the urine that filtrates from glomerulus
always shows abnormality. Cylindruria always occurs in various
Glomerulonephritis.
3. Proteinuria
Because of various inflammatory mediators and active substances, the
capillary permeability increases and protein leaks out and forms proteinuria,
which commonly occurs in various Glomerulonephritis. And due to the impairment
of charge barrier, protein leaks out and forms proteinuria, which is always seen
in Minimal Glomerulonephritis.
4. Hematuria
It is caused by the increased glomerular capillary wall or the rupture of
capillary wall. It commonly occurs in Endocapillary Proliferative
Glomerulonephritis, Crescentic Glomerulonephritis, Membrano-Proliferative
Glomerulonephritis and Focal Glomerulonephritis.
5. Oliguria and Anuria
In oliguria, the urine volume is less than 400ml/24h; in anuria, it is less
than 100ml/24h. The main reasons for oliguria and anuria are as follows;
① Glomerular endothelial calls proliferate and lead to narrow or blocked
capillary lumens and decreased glomerular filtration rate. These diseases
include Endocapillary Proliferative Glomerulonephritis, Membrano-Proliferative
Glomerulonephritis, etc.
② A large amount of crescents come into being and block renal capsules, for
example, the Crescentic Glomerulonephritis.
③ Most nephrons are damaged and vanish, which lead to difficult production of
initial urine, for example, the Sclerosing Glomerulonephritis.
6. Renal Hypertension
Renal high blood pressure is closely related to the following two
aspects:
① Due to the ischemia state of glomerulus, the excretion of renin goes
up;
② Oliguria and anuria cause the retention of water and sodium and the
increase of effective circulating blood volume, which always occurs in
Endocapillary Proliferative Glomerulonephritis, Membrano-Proliferative
Glomerulonephritis, Crescentic Glomerulonephritis and Sclerosing
Glomerulonephritis.