Nephrotic syndrome – treatment of disease. Symptoms and prevention of the disease nephrotic syndrome

Nephrotic syndrome – What is this disease? Nephrotic syndrome is a symptom, emerging against the backdrop of kidney failure and includes massive proteinuria, violation of protein-lipid metabolism and swelling.

Nephrotic syndrome – The cause of the

Origin can be primary nephrotic syndrome (complicating independent kidney disease) or secondary (a consequence of diseases, proceeding with secondary kidney involvement).

Primary nephrotic syndrome occurs when glomerulonefrite, pyelonephritis, primary amiloidoze, nephropathy pregnant, Kidney tumors (gipernefrome) and etc.

Secondary development of nefroticski syndrome can be caused by many conditions: kollagenozami and rheumatic lesions (SLE, uzelkovm periarteriitom, haemorrhagic vaskulitom, Scleroderma, rheumatism, Rheumatoid arthritis); nagnoitel'nymi processes (bronchiectasis, Lung abscess, septic endocarditis); diseases of the lymphatic system (Lymphoma, Hodgkin's disease); infectious and parasitic diseases (tuberculosis, malaria, syphilis) etc.. In some cases nephrotic syndrome develops against the background of drug illness, severe allergies, heavy metal poisoning (mercury, lead), bee stings and snake, and so. d.

Sometimes, mainly in children, the cause of nefroticski syndrome cannot detect, enabling the highlight option disease idiopathic.

The symptoms of nephrotic syndrome

Signs of nefroticski syndrome are similar, Despite of distinction of reason.

The lead serves as the manifestation of proteinuria, reaching 3,5-5 and more g/day, with up to 90% displayed with urine protein form the albumins. Massive protein loss in the urine causes the decrease in the level of General whey protein to 60-40 and less g/l. Fluid retention in nefroticescom syndrome can manifest peripheral swelling, ascites, anasarkoj (generalized swelling subcutaneous tissue), gidrotoraksom, gidroperikardom.

Progression of nefroticski syndrome accompanied by general weakness, dryness in the mouth, the thirst for, loss of appetite, headache, the severity of back pain, vomiting, vzdutiem life, diarrhea. A characteristic feature of nefroticski syndrome serves oliguria with daily diurezom less 1 l.

There phenomenon paresthesia, myalgia, convulsions. Development of hydrothorax and gidroperikarda causes shortness of breath with motion and at rest. Peripheral edema shackle the motor activity of the patient. Patients with nephrotic syndrome limp, sedentary, pale; Note the increased peeling and dryness, brittle hair and nails.

Nephrotic syndrome can develop gradually or rapidly; be accompanied by less and more symptoms, that depends on the nature of the flow of the main disease. On clinical flow vary 2 Variant of nefroticski syndrome-pure and mixed. In the first case of nephrotic syndrome occurs without hematuria and hypertension; the second could take nefroticheski-gematuricheskuju or nefroticheski-hypertonic form.

Complications of nefroticski syndrome may result in peripheral flebotrombozy, Viral, Bacterial, fungal infections, swelling of the brain or retina, principally Kriz (hypovolemic shock).

Nephrotic syndrome – Diagnostics

In nefroticescom syndrome an objective examination reveals pale («Pearl»), cold and dry to the touch skin, coated tongue, increasing the size of the abdomen, hepatomegaly, swelling. When gidroperikarde noted the expansion of heart and muting tones; When gidrotorakse-shortening perkutornogo sound, relaxed breathing, stagnant melkopuzyrchatye wheezing. On the ECG recorded aetiology, signs of degeneration of the myocardium.

In the overall analysis of urine in nefroticescom syndrome is defined by high relative density (1030-1040), leucocyturia, цilindrurija, the presence of cholesterol crystals in the sludge and drops of neutral fat, seldom-mikrogematuria.

In the peripheral blood increased ESR (to 60-80 mm / h), passing eozinofilia, the increase in the number of platelets (to 500-600 thous.), a slight decrease in hemoglobin and red blood cells. Clotting, detected by a study coagulation diagram, can be expressed in a small improvement or development of signs of disseminated intravascular coagulation syndrome.

Study on the biochemical analysis of blood in nefroticescom syndrome reveals the characteristic gipoal'buminemiju and gipoproteinemiju (less 60-50 g / l), giperholesterinemiju (cholesterol more 6,5 mmol / l); In biochemical analysis of urine is defined proteinurija over 3,5 g per day.

To ascertain the severity of renal tissue changes in nefroticescom syndrome may require holding a renal ultrasound, USDG renal vessels, nefroscintigrafii.

Nephrotic syndrome – Actions of the patient

Consult your doctor, If you find yourself in the symptoms of nephrotic syndrome. Consult your doctor if new symptoms, such as urination, discomfort during urination, fever, Strong headache, rash. Call an ambulance, If you have new symptoms.

nephrotic syndrome treatment

Common treatment interventions, not dependent on etiology of nefroticski syndrome, serve as the appointment of a constrained liquid diets bessoleva, bed rest, symptomatic drug therapy (diuretics, potassium products, antihistamines, vitamins, Cardiac tools, antibiotics, geparina), albumin infusion, reopoligliukina.

In nefroticescom syndrome ambiguous Genesis, as well as due to a toxic or autoimmune kidney lesion, shows the steroid therapy prednisone or methylprednisolone was introduced (oral or intravenous pulse therapy mode). Immunosuppressive therapy with steroids suppresses the formation of antibodies, CEC, improves kidney bloodstream and clubockovu filtering.

A good therapeutic effect of treatment gormonorezistentnogo of nefroticski syndrome achieves zitostatical therapy with cyclophosphamide and hlorambucilom, the ongoing pulse-rates.

Nephrotic syndrome – Complications

When the remaining causes of nephrotic syndrome can take over with relapsing or persisting outcome in chronic kidney failure.

Prevention of nephrotic syndrome

Prevention involves early and thorough treatment of renal and vnepochechnoj pathology, that could be complicated by the development of nefroticski syndrome, careful and controlled use of medicines, possessing nefrotoksicski and allergic effect.