Nephrotic syndrome in children

Nephrotic syndrome in children

Typical symptoms: edema is the most common clinical manifestation. Often found as early as parents. Starting from the eyelids, face, gradually and limbs.

Symptoms: ascites, chronic renal insufficiency, hypoproteinemia, venous thrombosis, scrotal edema, proteinuria, edema

First, symptoms

1, edema

The degree of edema was different in children, and the edema of both lower limbs was obvious. Edema due to gravity changes, long or early in the eyelids, back, sacral edema significantly, after the activity of lower extremity edema. Severe edema and systemic, scrotal edema or pleural and peritoneal effusion, and even pericardial effusion. High degree of edema in the local skin shiny, thin skin, and even white (mostly in the abdomen, buttocks and thighs). Serous effusion often produces symptoms such as chest tightness, shortness of breath, or difficulty breathing. There are often milky white chest, ascites, containing emulsified lipids. The degree of edema was not related to the severity of the disease and the severity of the disease. In patients with minimal change, there is a high degree of systemic edema, membranous nephropathy and proliferative glomerulonephritis are common. Edema is a significant manifestation of a certain stage of glomerular disease process, some patients may be reduced by several months or 1 ~ 2 years. Edema is often related to sodium intake. Decreased urine volume.

2, proteinuria

Children with nephrotic syndrome in children with hematuria will contain a lot of protein, children more than 50mg/ (kg? D).

3, hypoproteinemia and malnutrition

Long term massive protein loss leads to malnutrition. Patients with sparse hair, and yellow color, simply light white, muscle wasting and malnutrition performance etc.. The plasma concentration of other proteins also changed in the case of hypoalbuminemia. A small molecular weight and a protein similar to that of albumin, mainly from urine. Low serum albumin concentration was lower than 25g/L.

4, hyperlipidemia

Mainly due to the low blood cholesterol leading to the synthesis of cholesterol in the liver, three acyl glycerol and phospholipids increased, decreased catabolism, decreased plasma osmotic pressure also led to an important factor in hyperlipidemia.

The above four characteristics of nephrotic syndrome.

5, secondary infection

Immune dysfunction, a large number of protein loss, malnutrition and other factors are likely to secondary infection. Due to the lack of B factor in the complement system, the loss of serum regulatory activity, and the increase of catabolism and the loss of urine from the kidney, the body's anti infection ability is reduced, so it is easy to be infected. Common for respiratory tract infections, urinary tract infections, skin infections, primary peritonitis, sepsis, intestinal infections, pneumonia, etc..

6, high coagulation state

The majority of patients were in a hypercoagulable state with a tendency to clot. Many scholars believe that the platelet dysfunction is the cause of chronic immune complex nephritis glomerular damage. Hypercoagulable state is easy to promote the formation of intravascular thrombosis, glomerular fibrin, and further deterioration of renal function. In the process of NS, if renal vein thrombosis is formed, the congestion in the kidney is more serious, the renal volume is enlarged, the renal function is further reduced, the edema and proteinuria are increased.

7, renal insufficiency

Renal dysfunction may occur in patients with nephrotic syndrome. There are two types of renal insufficiency, acute and chronic. Acute manifestations of acute nephritic syndrome, and prone to oliguria acute renal failure. Acute renal failure occurred in the patients with minimal change and slight nephropathy. In the period of severe edema or significant pathological changes, renal dysfunction was often accompanied by increased serum urea nitrogen and creatinine. In patients with chronic glomerulonephritis, even if the edema completely subsided, the majority of renal function can not return to normal. NS is sensitive to glucocorticoid, and the renal function is normal, so it will not happen in chronic renal insufficiency. The renal function is normal in the early stage of membranous nephropathy. In patients with membranous proliferative glomerulonephritis, most of them had renal dysfunction at the onset of the disease. Clinical manifestations can be acute and slow. Before the onset of respiratory infection or skin infections, etc., can also be no incentive. Systemic severe edema is a prominent symptom of the disease, with a decrease in urine volume. Some children with hematuria (hematuria), some children have high blood pressure, some patients can have severe edema with pleural effusion and ascites.

 

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