1, urine routine found positive for urine protein and/or occult blood, but no symptoms, is this chronic nephritis? Nowadays, there are more medical checkups and more people checking urine routine, so there are more people found positive for urine protein and occult blood (urine red blood cells). First of all, it should be clear that once there is a positive urine protein and or positive occult blood, consider that there may be a problem with the kidney. Under normal circumstances there will be a very small amount of protein and red blood cells in the urine, which is usually not found positive; once the standard is exceeded (showing positive), it indicates that the kidneys are damaged and something is wrong. Of course, a positive result once in a while does not mean that there is a problem with the kidneys, it still needs to be reviewed and monitored. What we mean by hematuria and proteinuria is persistent. Glomerular diseases include kidney damage caused by primary, secondary and hereditary diseases. Glomerular diseases are typed clinically and include five syndromes: acute glomerulonephritis (also often called acute nephritis) syndrome, acute progressive glomerulonephritis syndrome, chronic glomerulonephritis (often called chronic nephritis) syndrome, occult glomerulonephritis (cryptogenic nephritis, also called asymptomatic hematuria or/and proteinuria) and nephrotic syndrome. Chronic nephritis, which is just one type of glomerular disease. These proteinuria and/or hematuria positive found on physical examination without discomfort can be called occult glomerulonephritis. 2.Is the proteinuria detected once in a while also considered as nephritis? There is a kind of proteinuria called functional proteinuria, such as proteinuria that occurs with high fever, intense exercise or upright position for too long, which is mostly transient and physiological and was once considered to be okay; but now it is found that the so-called physiological proteinuria is not necessarily completely okay – a significant number of people have had a kidney puncture biopsy Later, their kidneys are found to have some problems. Therefore, for the occasional proteinuria, we should pay attention to it and should review it regularly, for example, once every six months or once a year; of course, you can also consider doing a kidney puncture, but many people may not be able to accept it, and doctors do not advocate that all people do kidney puncture for this reason, so you can review the urinary routine or 24-hour urine protein quantification regularly first. 3.If only hematuria or urine occult blood is positive, and other indicators such as urine protein are negative, what tests are needed to determine whether chronic nephritis is present? At this time, morphological analysis of urine red blood cells should be done. Because when the kidney is damaged, the red blood cells in the blood need to pass through many barriers in the process of running to the urine, during which they will be distorted by different degrees of extrusion, and the morphology is different from that of normal red blood cells in the blood; on the contrary, if the hematuria is caused by kidney stones or urinary tract infection, the red blood cells in the urine are from the mucosal surface and do not need to pass through the barrier in the glomerulus, so the morphology is The morphology is the same as that of normal red blood cells. This test is called urine red blood cell microscopy in some hospitals and urine red blood cell phase examination in others, but in fact the contents are the same. 4. Why is chronic nephritis diagnosed as soon as it is found, instead of acute nephritis? Does “chronic” mean that it will slowly progress to uremia? Many patients have this misconception, thinking that chronic nephritis is not treated before and become chronic. In fact, what we call acute nephritis and chronic nephritis is not divided according to the time of first onset, it is not the same as the concept of acute appendicitis and chronic appendicitis or acute pancreatitis and chronic pancreatitis; acute or chronic is divided according to clinical manifestations and pathological types. In general, as long as there is proteinuria, we consider chronic nephritis; while acute nephritis is more dominated by hematuria, and the degree of hematuria is also more serious, often young or children are more common, especially after the occurrence of tonsillitis. The prognosis of chronic nephritis is mainly related to the type of pathology, for example, the treatment effect of thylakoid proliferative glomerulonephritis, microscopic lesion type is better, but microscopic lesion type also has a problem – easy to relapse; and membrane nephropathy is more difficult to treat, but it also has another “benefit The treatment of membranous nephropathy is more difficult, but it also has another “advantage” – the pathological development is relatively slow; in addition, like crescentic and necrotizing glomerulonephritis or some focal sclerosing glomerulonephritis, the treatment effect is poor. Patients as well as their families should not have such negative emotions, because most of the current treatment results are relatively good, and some patients have a stable condition for more than ten years after treatment. Nowadays, medical science is developing rapidly, and active treatment can delay the development of the disease. Even if there is renal insufficiency, doctors have the appropriate means to deal with it and slow down the decline of kidney function; even at the stage of uremia, dialysis treatment can be done.