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Nephrotic syndrome has several major complications we must b

Dec 28, 2016
Complications of NS are important factors affecting long-term prognosis of patients, should actively prevent and cure.
1 infection
Hormone therapy usually does not require antibiotics to prevent infection, otherwise not only can not achieve the purpose of prevention, but may lead to fungal superinfection. Once found infection, should be timely selection of pathogenic bacteria sensitive, potent and non nephrotoxic antibiotics active treatment, clear infection should be removed as soon as possible. Severe infection is difficult to control should be considered to reduce or disable hormones, but depending on the patient specific circumstances.
2 complications of thrombosis and embolism
It is generally believed that when plasma albumin is lower than 20g/L (idiopathic membranous nephropathy less than 25g/L) anticoagulant therapy can be given heparin sodium (also can choose low molecular heparin) subcutaneous injection or oral warfarin. At the same time can be supplemented with anticoagulant antiplatelet drugs such as aspirin, dipyridamole or oral. To have occurred thrombosis and embolism should be early (within 6 hours is best, but 3 days is still expected to be effective) treated with urokinase or streptokinase systemic or local thrombolysis, combined with anticoagulation, anticoagulation should generally be sustained application of more than half a year. Anticoagulant and thrombolytic therapy should avoid excessive drug bleeding.
3 acute renal failure
NS complicated with acute renal failure, such as improper treatment can be life-threatening, if given the right treatment in a timely manner, most patients are expected to recover. Can take the following measures:
(1) loop diuretics remain in effect for loop diuretics should be larger dose to scour blocking renal tubule type;
(2) hemodialysis diuretic ineffective, and has reached dialysis indications, should give hemodialysis to maintain life, and supplement plasma products after appropriate dehydration, in order to reduce renal interstitial edema;
(3) the primary treatment is minimal pathological nephropathy due to its pathological type;
(4) alkaline urine oral sodium bicarbonate alkaline urine, in order to reduce the formation of tube type.
4 protein and fat metabolism disorders
It is often difficult to completely correct metabolic disorders before NS remission, but the amount and structure of protein and fat in the diet should be adjusted to minimize the effects of metabolic disorders. At present, many drugs can be used to treat protein and fat metabolism disorders. Such as: ACEI and angiotensin II receptor antagonist can reduce urinary protein; studies have shown that Astragalus membranaceus can promote liver albumin synthesis, and may both reduce the role of hyperlipidemia. Lipid-lowering drugs can choose cholesterol based hydroxymethylglutaryl coenzyme A reductase (HMG-CoA) inhibitors, such as statins such as lovastatin; or triglyceride lowering mainly clofibrate, fenofibrate as such. After NS remission hyperlipidemia can be naturally relieved, then no need for continued medication.

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