Renal disease in syphilis – state and urinalysis

Sifiliticheskaya nephropathy divided into early and late. By the early nephropathy refers benign vascular kidney disease, which is manifested transient proteinuria and hematuria, arising Soon after infection with syphilis. These phenomena are not accompanied by the appearance of swelling, high blood pressure and the change in the fundus. Changes in the kidneys observed before treatment, therefore it can not be regarded as a consequence of therapy with bismuth and mercury.

More severe renal disease syphilis is lipoid nephrosis, arising, apparently, due to the action of toxins Treponema pallidum in the renal parenchyma. Suggest, that while the primary is the total lipid metabolism in the body, leads to the development of degenerative changes in the kidneys.

In patients with secondary syphilis lipoid nephrosis characterized by significant proteinuria (to 20- 30 g / l and more). Relative density mochi- 1,04. In a lot of urine sediment cylinders, leukocytes, erythrocyte. Hypoproteinemia observed and hypercholesterolemia.

When treating drugs bismuth in patients with syphilis may occur nephropathy (15-20% of patients in the second half of the course of treatment). In the initial stage of the disease appear in the urine bismuth cells - degenerated renal epithelial cells increased, containing cytoplasm dark crystals. Their appearance indicates irritation of the kidneys, does not require discontinuation of treatment. When the urine protein and cylinders needed a break in treatment for 7-10 days. During treatment, the patient must be investigated urine once in 5-7 days.