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nephrotic syndrome examination items

Dec 24, 2016
1 nephrotic syndrome examination items
Laboratory examination:
1 simple nephrotic urine, urinary protein qualitative to quantitative ~ 24h; more than 0.1g/kg, with occasional transient small amounts of red blood cells. Nephropathy in addition to varying degrees of proteinuria, but also microscopic or gross hematuria.
2 blood biochemical measurements showed hypoproteinemia (serum albumin <30g/L, baby <25g/L), albumin and globulin ratio inversion, serum protein electrophoresis showed that the globulin increased; blood cholesterol increased significantly (children >5.7mmol/L, baby >5.1mmol/L).
3 renal function can be detected in oliguria period of mild mild renal disease, simple nephrotic kidney function more normal. If there are varying degrees of blood creatinine and elevated urea nitrogen, it is suggested that nephritic nephropathy.
4 serum complement determination helps to distinguish between simple nephropathy and nephritis nephropathy, the former serum complement normal, the latter often have different degrees of low blood complement, C3 continued to reduce.
5 serum and urine protein electrophoresis by detecting IgG in urine constituents reflect selective proteinuria, and can identify false proteinuria and light chain proteinuria, if the ratio of gamma globulin and albumin in urine is less than 0.1, for selective proteinuria (tips for nephrotic), more than 0.5 non selective proteinuria (hint as nephritic type nephrotic syndrome).
6 serum immunological tests for detecting antinuclear antibodies, anti double stranded DNA antibody, anti Sm antibody and anti RNP antibody, anti histone antibody, hepatitis B virus markers and rheumatoid factor, circulating immune complexes, to distinguish between primary and secondary nephrotic syndrome.
7 blood coagulation and fibrinolysis detection related proteins such as fibrinogen and V, VII and VIII and X factor, antithrombin III, urinary fibrin degradation products (FDP) and the detection can reflect the coagulation state, provide the basis for whether to take anticoagulant therapy.
8 urine enzyme determination of urine lysozyme, N- acetyl - beta - glucosidase (NAG) and so on to help determine whether the presence of tubulointerstitial damage.
Two, other inspection:
1 B ultrasound imaging examination exclude congenital malformations of the kidney.
2 percutaneous renal puncture biopsy for the diagnosis for treatment of nephritic nephrosis or glucocorticoid bad children should be timely for renal biopsy, to further clarify the pathological type, in order to guide treatment.

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