Treatment of edema in nephrotic syndrome

Treatment of edema in nephrotic syndrome

Sodium restriction diet: edema itself indicates excessive sodium in the body, so it is important for patients with nephrotic syndrome to limit the intake of salt. The average daily intake of salt is 10g (containing 3.9G sodium), but because of sodium restriction, the patient often loses his appetite because of his bland diet, which affects the intake of protein and calories. Therefore, the sodium restriction diet should be tolerated by the patient, without affecting its appetite, and the salt content of the low salt diet is 3 to 5g/d. Chronic patients, due to long-term sodium restriction diet, can lead to intracellular sodium deficiency, should be noted.

Treatment of edema in nephrotic syndrome

Diuretic use: according to different parts of the action, diuretics can be pided into:

Loop diuretics: the main role mechanism is the inhibition of medullary ascending limb of chlorine and sodium reabsorption, such as furosemide and bumetanide enantiomers as the most powerful diuretic. The dose of furosemide and bumetanide 20 ~ 120mg/d, 1 ~ 5mg/d.

Thiazide diuretics: a major role in the me dullary thick ascending branch of loop segment and distal tubule segment, through reabsorption inhibition of sodium and chlorine, increased potassium excretion and achieve a diuretic effect. The common dose of hydrochlorothiazide is 75 to 100mg/d.

The excretion of sodium retention of potassium diuretics: a major role in the distal tubule and collecting duct, for aldosterone antagonists. The usual dose of spironolactone was 60 ~ 120mg/d, the use of such drugs is poor effect alone, so often and excretion of potassium diuretic.

Osmotic diuretics: free filtration of the glomerulus without reabsorption by the renal tubule, thereby increasing the osmotic concentration of the renal tubule and preventing reabsorption of sodium from the proximal tubule and distal tubule to achieve diuresis. The common dose of low molecular dextran 500ml/2 ~ 3d, mannitol 250ml/d, pay attention to renal impairment, caution.

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