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Clinical manifestations and health guidance of nephrotic syn

Dec 26, 2016
Nephrotic syndrome is due to various diseases caused by kidney, with massive proteinuria (urine protein greater than 3.5g/d) and hypoalbuminemia (serum albumin less than 30g/L), edema, hyperlipidemia, clinical manifestations of a syndrome.
Clinical manifestation 1 massive proteinuria massive proteinuria refers to the urine protein quantification >3.5g/d. In normal physiological conditions, glomerular filtration membrane has molecular barrier and charge barrier, resulting in increased protein content in the original urine, when far more than the proximal tubule absorption, the formation of a large number of proteinuria. On this basis, every increase in glomerular pressure and lead to high perfusion, high filtration factors (such as hypertension, high protein diet or massive infusion of plasma protein) can aggravate urinary protein excretion. 2 hypoproteinemia decreased plasma albumin to <30g/L. A large amount of albumin is lost from the urine during nephrotic syndrome, which promotes the compensatory synthesis of hepatic albumin and the increase of tubular decomposition. Hypoalbuminemia occurs when albumin synthesis is not sufficient to overcome loss and breakdown. In addition, patients with nephrotic syndrome due to gastrointestinal mucosal edema leading to poor appetite, insufficient protein intake, malabsorption or loss, also aggravate hypoproteinemia. Besides the reduction of plasma albumin, some plasma immunoglobulin and complement components (such as IgG), anticoagulation and fibrinolytic factors, metal binding proteins and endocrine hormone binding protein can also be reduced, especially the large amount of proteinuria, glomerular pathological damage and non selective proteinuria is more significant. Patients are prone to infection, high coagulation, trace element deficiency, endocrine disorders and immune dysfunction and other complications. 3 when the nephrotic syndrome, hypoalbuminemia, plasma colloid osmotic pressure decreased, so that water from the vascular cavity into the interstitial space, is the basic cause of edema. 4 hyperlipidemia nephrotic syndrome often accompanied by hyperlipidemia. Among them hypercholesterolemia is the most common; triglycerides, low-density lipoprotein, very low-density lipoprotein can also be increased.
Health guidance (1) severe edema, low blood pressure patients need bed rest, while maintaining moderate bed and bedside activities to avoid thrombosis, improved symptoms, moderate increase in activity. Pay attention to strengthen skin cleaning and protection, prevent infection. (2) normal renal function may be a normal amount of high protein diet, protein per day per kilogram of body weight 0.8 ~ 1.0g is appropriate, such as milk, egg, fish, lean meat are high quality protein; to ensure sufficient heat, per kg body weight per day should not be less than 30 ~ 35kcal; edema should be low salt (<3g/d) diet. In order to reduce hyperlipidemia, should be less rich in saturated fat (animal fat) diet, and eat more rich in polyunsaturated fatty acids (such as vegetable oil, fish oil) and rich in soluble fiber (such as beans) diet. (3) when edema, pay attention to control the amount of water into the volume.
Hormone therapy notes (1) glucocorticoids can lead to elevated blood sugar, long-term use of hormones can make the fat metabolism, glucose metabolism disorders, can also cause water sodium retention, serious person can cause hyperlipidemia, diabetic mellitus and hypertension, so in the long-term use of hormone in patients, promote low carbohydrate diet and a low salt diet (2) long-term use of hormones, can also cause the metabolism of calcium and phosphorus, bone calcium loss caused by osteoporosis, so medication usually recommend calcium supplements at the same time. (3) taking hormone may cause acne and skin purple lines, so we should pay attention to keep skin health, prevent skin infections, increase induced proteinuria, also should eat less spicy spicy food, can be timely to eat some vitamin C of fruits and vegetables, in order to increase the repair of skin. (4) hormone should be taken after meals, while taking protective gastric mucosa drugs. (5) take medicine strictly according to doctor's advice, do not change dosage or stop drug. (6) attention to oral, skin cleaning and food hygiene, attention to warm, prevent infection.

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