How to check patients with interstitial nephritis2017-02-28 15:39
1 urine examination
Generally a small amount of low molecular weight proteinuria, urinary protein in 0.5 ~ 1.5g/24h, little >2g/h; examination of urinary sediment had microscopic hematuria, white blood cells and cylindruria, even with eosinophils. Renal tubular dysfunction is different according to the location and extent of the involvement of the tubules, and may have renal diabetes, renal tubular acidosis, hypotonic urine, Vankoni's syndrome, etc..
2 blood tests
Some patients may have hypokalemia, hyponatremia, low phosphorus and high chloride metabolic acidosis. Uric acid is normal or mildly elevated. The incidence of anemia in chronic interstitial nephritis is high and the degree is serious. Acute interstitial nephritis in patients with peripheral blood eosinophil ratio increased with the increase of IgE, idiopathic interstitial nephritis have anemia, eosinophilia, ESR fast, CRP and globulin increased.
3 imaging examination
Acute interstitial nephritis can show the normal size or volume of the kidney, and cortical echo enhancement. Chronic interstitial nephritis B ultrasound, radionuclide, CT and other imaging examination usually shows that the double kidney narrowing, kidney contour is not whole. Imaging examination can also help to determine some specific causes, such as urinary tract obstruction, bladder reflux, renal cystic disease, etc.. Intravenous urography (IVU) showed signs of renal papillary necrosis of analgesic nephropathy. The contrast agent has renal toxicity, therefore, in the renal tubular injury should be used with caution.
4 renal biopsy pathology
Pathological examination is important for diagnosis. In addition to infection associated acute interstitial nephritis, other types should be actively performed renal biopsy, to differentiate renal interstitial cell infiltration type and fibrosis degree, prognosis and help formulate treatment plan after.