Is uremia an inevitable outcome for patients with chronic glomerulonephritis?

  In China, the most common cause of uremia is chronic glomerulonephritis. In patients with chronic nephritis, the kidney parenchyma is damaged, resulting in the continuous destruction of kidney units, while the remaining surviving kidney units become compensatory hypertrophy to maintain the body’s needs in order to enhance the glomerular filtration function and the function of the renal tubules in processing filtrate. However, as the disease progresses, the number of surviving kidney units becomes less and less, and finally, the body is unable to meet the minimum requirements of metabolism even when it is exhausted, and finally develops into renal failure.  In chronic renal failure, the tubules of the surviving kidney units are also in a compensatory hypermetabolic state, with increased oxygen consumption, increased production of oxygen radicals, and a significant increase in ammonium production by renal tubular cells, which can cause tubular damage, interstitial inflammation and fibrosis, and even loss of kidney unit function. Also associated with hypertension, intrarenal hemodynamic changes, excessive protein and fat in the diet, endocrine hormonal disorders in the kidney lead to further loss of function of the diseased glomerulus, and eventually develop into renal atrophy and uremia. If the patient is accompanied by infection, exertion, pregnancy and application of nephrotoxic drugs, the kidney may be damaged, which may lead to the deterioration of renal function and accelerate the development of uremic syndrome.