The clinical manifestations of nephrotic syndrome are "three highs and one low", which are four signs of high edema, hyperlipidemia, large amount of proteinuria and hypoproteinemia. Edema is an early clinical manifestation, which is often regarded by parents and clinical workers. In addition to the above four symptoms, there are some cases with hematuria (microscopic or gross), hypertension or azotemia (elevated serum creatinine), such as the three one called "nephritic syndrome", and none of the above three symptoms as "simple nephrotic syndrome". The pathological changes, treatment options and prognosis are different.
Nephrotic syndrome etiology
Nephrotic syndrome can be pided into three main categories, primary, secondary and congenital, among which primary is more common in children. In recent years, due to the improvement of diagnosis of secondary kidney disease such as Henoch Schonlein Purpura Nephropathy, lupus nephritis, hepatitis B virus associated nephropathy rate was increased. Nephrotic syndrome under 2 years of age is referred to as infantile nephropathy. Within 1 years of age, congenital nephrotic syndrome is considered. Therefore, family history should be provided for infants with kidney disease.
Why do you need a kidney biopsy?
The pathological types of nephrotic syndrome are varied. Different pathological types are related to prognosis, and the corresponding treatment options are different. Generally speaking, the treatment of glucocorticoid sensitive without renal biopsy, but for steroid resistance, frequent relapse or steroid dependent and secondary nephropathy were renal biopsy indications for further diagnosis and treatment, prognosis, improve the remission rate of nephropathy. At present, the techniques and instruments of renal puncture have been greatly improved, and parents and related personnel should be exempted from unnecessary worries.
Problems should be paid attention to in the treatment
1., adhere to the kidney specialist out-patient follow-up, in order to facilitate long-term observation, the best treatment, remission after 5 years of follow-up.
2., avoid all kinds of (respiratory tract, digestive tract) infection, lead to kidney disease recurrence, frequent recurrence, etc., adverse to the disease.
3., in addition to severe edema, avoid long-term bogey salt, especially in summer, severe can cause low sodium syndrome, even shock, convulsions. With low salt (2 grams per day), soy sauce in the market contains about 2 grams of sodium salt per 10ml. It can not only avoid hyponatremia but also increase appetite.
4. during the acute phase of treatment, stop the prevention of immunity.
5., infection should avoid the use of antibiotics blindly, especially nephrotoxic antibiotics, so as to avoid large dosage or irrational use of diuretics. For a moment the blind diuretic often leads to hypovolemic shock, blood hypercoagulability and thrombosis.
6., the first glucocorticoid used in the treatment has strict dosage and course of treatment, and should not reduce or stop the medicine on the way. In some cases, highly sensitive to hormones, the treatment of urinary protein decreased, edema disappeared, this time as "better stop, just look at the surface of the blind reduction or withdrawal often caused by relapse or recurrence.
7. regular review of blood biochemical (renal function), urine routine, to determine the drug effect and the changes and recovery of the disease, so as to adjust the treatment plan at the time of follow-up.
The complete remission of nephrotic syndrome is called complete nephrotic syndrome after the complete disappearance of edema, the disappearance of multiple proteinuria, and the normal biochemical activity of the blood.
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