Glomerulonephritis

Zusammenfassung

Glomerulonephritiden sind eine Gruppe von Erkrankungen, die durch entzündliche Prozesse in der Niere charakterisiert sind und sich klinisch mit einem nephritischen oder nephrotischen Syndrom und einem Verlust der Nierenfunktion präsentieren. Oft sind Glomerulonephritiden von einer arteriellen Hypertonie oder Ödemen begleitet. Bei vielen Patienten sind die klinischen Symptome in der Frühphase der Erkrankung sehr mild oder fehlen ganz. So wird die Diagnose oft erst dann gestellt wenn schon ein beträchtlicher Verlust der Nierenfunktion vorliegt. Urinuntersuchungen zeigen bei Patienten mit Glomerulonephritiden in jeder Phase der Erkrankung pathologische Veränderungen. Urinuntersuchungen (Urinstix, Urinsediment) sollten deshalb bei jedem Patienten durchgeführt, sobald der Verdacht auf eine Nierenerkrankung vorliegt. Glomerulonephritiden können ausschließlich auf Glomeruli beschränkt sein, oder sich als begleitende Schäden bei systemischen Erkrankungen, meist Vaskulitiden, auftreten. Bei einigen Patienten reicht eine symptomatische Behandlung, während andere Patienten sich als medizinischer Notfall präsentieren. Bei diesen Patienten ist eine schnelle und intensive Behandlung erforderlich um den Verlust der Nierenfunktion zu verhindern. In dieser Übersichtsarbeit stellen wir die wichtigsten Glomerulonephritiden dar, fokusieren auf die Pathogenese, die diagnostischen Möglichkeiten und die Therapie. Das primäre Ziel ist die frühe Diagnose und eine an der Pathogense orientierte Therapie dieser Patienten.

Abstract

Glomerulonephritis encompasses a group of diseases that are characterized by inflammatory glomerular processes and clinically usually present with a nephritic and / or a nephrotic syndrome, as well as a deterioration of the renal function. Often, the diseases are accompanied by arterial hypertension and severe edema. In many cases however, the clinical symptoms are very mild or missing in the early phase of disease and therefore lead to a delayed diagnosis only after an impairment of renal function has developed. Urinalysis shows abnormalities in the very early phases of glomerulonephritis and should be performed in all patients, as soon as any evidence of renal involvement is present. Glomerulonephritis may occur primarily in the glomeruli, or present as renal involvement in the context of systemic diseases, most often vasculitis. In some cases, a symptomatic therapy is sufficient, while in other patients, a glomerulonephritis may represent as a medical emergency, which should be immediately and aggressively treated in order to prevent loss of renal function. Here we summarize the most important entities of glomerulonephritis, focusing on the pathogenesis, diagnostic tools and treatment options. The primary goal is the early diagnosis and a targeted, effective treatment of these patients.

Schlüsselwörter

Glomerulonephritis - Pathogenese - Diagnostik - Therapie

Keywords

glomerulonephritis - pathogenesis - diagnostic tools - treatment

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