Nephrotic syndrome pided into 3 categories according to different pathological types : primary nephrotic syndrome, congenital nephrotic syndrome and secondary nephrotic syndrome. There are four characteristics of clinical manifestations of nephrotic syndrome：a large number of proteinuria, edema, hypoproteinemia, hyperlipidemia. Here to give you a specific introduction to the clinical manifestations of nephrotic syndrome.
A large number of proteinuria: a large number of proteinuria is the most important clinical manifestations for NS patients, also the most basic pathophysiological mechanism of nephrotic syndrome. A large number of proteinuria refers to adult urinary protein excretion> 3.5g / d. In normal physiological conditions, glomerular filtration membrane has a molecular barrier and charge barrier, resulting in increased protein content in the original urine, far more than the proximal tubule back to the amount of absorption, the formation of a large number of proteinuria. On this basis, any increase in glomerular pressure and cause high perfusion and high filtration factors (e.g., hypertension, high protein diet or massive infusion of plasma proteins) can aggravate urinary protein excretion.
Hypoproteinemia: plasma albumin down to <30g / L. A large number of albumin lost from the urine at NS, promote albumin liver compensatory synthesis and increased renal tubular decomposition. Low albuminemia occurs when the increase in liver albumin synthesis is insufficient to overcome loss and breakdown. In addition, NS patients with gastrointestinal mucosal edema leading to poor appetite, lack of protein intake, poor absorption or loss, but also increase the cause of hypoalbuminemia.
Edema:Hypoalbuminemia, plasma colloid osmotic pressure decreased, so that water from the vascular cavity into the tissue gap, is the basic cause of NS edema. Recent studies have shown that about 50% of patients with normal or increased blood volume, plasma renin levels normal or decreased, suggesting that some of the primary renal sodium, water retention factors play a role in the pathogenesis of NS edema.
Hyperlipidemia: The reason why NS is associated with hyperlipidemia is not yet fully elucidated. High cholesterol and / or hypertriglyceridemia, serum LDL, VLDL and lipoprotein (α) concentration increased, often associated with hypoproteinemia. Hypercholesterolemia is mainly due to increased liver lipoprotein production, but in the surrounding cycle to reduce the decomposition also play a part. Hypertriglyceridemia is mainly due to catabolic disorders, liver synthesis increased as a secondary factor.
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