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Nephrotic syndrome complications

May 17, 2017

Infection: usually in the hormone treatment, there is no need to use antibiotics to prevent infection, otherwise, not only can not achieve the purpose of prevention, but may induce double infection of fungi. Once the infection is found, timely selection of pathogenic bacteria, sensitive, powerful and no nephrotoxicity antibiotic positive treatment, there is a clear infection should be removed as soon as possible. When severe infection is difficult to control, we should consider reducing or stopping the hormone, but depending on the patient's condition.
Thrombosis and embolism complications: generally, when serum albumin less than 20g/L (idiopathic membranous nephropathy below 25g/L) when anticoagulation therapy can be given heparin sodium (also used low molecular weight heparin) subcutaneous injection or oral warfarin. Anticoagulation can also be accompanied by antiplatelet agents such as dipyridamole or aspirin orally. 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 use leading to bleeding.
Acute renal failure: NS complicated with acute renal failure, such as improper treatment can be life-threatening, and if properly treated in a timely manner, most patients are expected to recover. You can take the following measures: loop diuretics is still valid for diuretics should be larger dose, to scour the blocking renal tubule; blood dialysis diuretic is invalid, and has reached the indications for dialysis, dialysis to sustain life, and in the appropriate supplement blood products after dehydration, to reduce renal interstitial edema; the treatment of primary disease because of its pathological type is minimalchange nephropathy, should be actively treated; alkaline urine oral sodium bicarbonate alkaline urine formation to reduce tube type.
Disorder of protein and fat metabolism: it is difficult to completely correct metabolic disorder before NS remission, but the amount and structure of protein and fat in diet should be adjusted, and the effect of metabolic disorder should be reduced to a minimum. At present, many drugs can be used to treat protein and fat metabolism disorders. Such as: ACEI and angiotensin II receptor antagonists can reduce urinary protein; some studies suggest that Astragalus membranaceus can promote albumin synthesis in the liver, and may also 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. NS after remission, hyperlipidemia can be a natural remission, there is no need for continued drug treatment.

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