”I have no symptoms, check the kidneys and so on are normal, just check the urine, the urine has protein ‘3+’, occult blood ‘2+’ …… ” “Today I went for a urine routine review, except for a urine protein is a ‘+’ inside, other indicators are nothing abnormal ……” Patients in the consulting area can see a lot of similar to the above description, they all have a common question – “Is this chronic nephritis?” 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 urine tests, so there are more people with positive urine protein and positive occult blood (urine red blood cells). First of all, it should be clear that once there is positive urine protein and positive occult blood, it is considered 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 and needs to be reviewed and monitored yet. What we mean by hematuria and proteinuria is persistent. Glomerular diseases include kidney damage caused by primary, secondary and hereditary diseases. Glomerular diseases are clinically typed and include five syndromes: acute glomerulonephritis (also commonly known as acute nephritis) syndrome, acute progressive glomerulonephritis syndrome, chronic glomerulonephritis (commonly known as chronic nephritis) syndrome, occult glomerulonephritis (occult nephritis, also known as asymptomatic hematuria or/and proteinuria), and nephrotic syndrome. Chronic nephritis, it is only one type of glomerular disease. These positive proteinuria and/or hematuria found on physical examination without discomfort can be called occult glomerulonephritis. Is proteinuria detected once in a while also considered as nephritis? There is a type of proteinuria called functional proteinuria, such as proteinuria that occurs with high fever, intense exercise, or being in an upright position for too long. This condition is mostly transient and physiological and was once considered to be okay; however, it is now found that the so-called physiological proteinuria is not necessarily completely okay – a significant number of people who have had a kidney puncture biopsy Later, it is found that there are some problems with their kidneys. Therefore, we should pay attention to the proteinuria that is occasionally detected, and we should review it regularly, for example, once every six months or once a year; of course, we can also consider having a kidney puncture, but many people may not be able to accept it, and doctors do not advocate everyone to have a kidney puncture for this reason. If only hematuria or urine occult blood is positive, but 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. 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 deformed by different degrees of extrusion, and the morphology is different from that of the 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 come 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 erythrocyte microscopy in some hospitals and urine erythrocyte phase examination in others, but the contents are actually the same. Why was chronic nephritis diagnosed as soon as it was found, instead of acute nephritis? Does “chronic” mean that it will slowly progress to uremia? Many patients have the misconception that chronic nephritis is the result of not being treated before and becoming 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 proteinuria is present, we consider chronic nephritis; while acute nephritis is more predominantly hematuria and the degree of hematuria is more severe, often in young or children, 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 glomerulonephritis and microscopic lesions is better, but microscopic lesions also have 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; and the treatment of crescentic and necrotizing glomerulonephritis or some focal sclerosing glomerulonephritis is less effective. 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 development is fast, active treatment can delay the development of the disease, even if there is renal insufficiency, doctors have the appropriate means to deal with it, slowing down the decline of kidney function; even to the stage of uremia, you can do dialysis treatment