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Nephrotic syndrome is a type of kidney disease that causes too much protein to be excreted in the urine.
Sections of nephrotic syndrome
Nephrotic syndrome in infancy and infancy is divided into three main groups:
1. Nephrotic syndrome due to general diseases
These are diseases that affect different organs, including the kidneys, including:
diabetes.
Lupus erythematosus.
Various vascular diseases, such as: Henoch schonlein purpura.
Viral inflammation of the liver.
carcinoid tumors;
The outlook for diseases and their treatment changes according to the type of disease and the extent of damage to the various organs, including the kidneys.
2. Congenital nephropathy
It is a genetically inherited disease that appears shortly after birth, but it is also possible to recognize the disease during the embryonic period.
The hereditary forms of nephrotic syndrome are stable in treatment, and most patients develop kidney failure.
3. Primary nephrotic syndrome
It is a syndrome of unknown etiology, which indicates that the course of the disease's development is not clear. This type is common in childhood.
In general, this type can be divided into two main groups:
The first group
In the nephrotic syndrome that distinguishes the first group through the microscope, we can see a healthy kidney or with minor changes (minimal change disease), and in this group there is a good response to treatment with steroid drugs, and most cases do not end in kidney failure.
On the other hand, the disease sometimes appears in the form of repeated and successive episodes, and these cases dictate treatment with steroids, despite all the side effects caused by the use of the drug.
the second group
In the second group, there is a prominent result of seeing the kidneys through a microscope, and it includes several subgroups, each subgroup is unique and is characterized by microscopic changes, and only a few of these groups respond to treatment with steroids and the condition does not progress to kidney failure.
In both groups, some drugs are used to inhibit the process of rejection after organ transplantation, and the function of these drugs is to reduce the doses of steroids given, in order to reduce side effects.
Symptoms of nephrotic syndrome
Nephrotic syndrome is characterized by four manifestations, which are as follows:
1. Excess protein in urine
Each kidney includes a large number of renal units (Nephrons), and the first part of the renal unit is composed of pores containing blood vessels and glomeruli that enable the transit of fluids and salts, and prevent the transit of blood cells of all kinds and different blood proteins.
In nephrotic syndrome, the glomeruli are damaged, and this defect enables the passage of blood proteins that can be found in the urine.
Of these proteins, albumin appears in very high amounts in the urine, and this easy transit of the protein from the blood into the urine occurs due to the relatively small molecular size of this protein compared to other blood proteins.
2. Hypoalbuminemia
Low concentration of albumin in the blood, this phenomenon results from the loss of albumin in the urine, and also due to its decomposition in the cells of the kidney.
3. Edema
It is the retention of fluids in the body, and it most likely begins in the eyelids, and causes swelling in the lower extremities, in the abdominal cavity, and in the cavity of the lung membrane.
These signs often lead to a diagnosis of nephrotic syndrome.
The reason behind the appearance of edema is a decrease in the concentration of albumin in the blood resulting from a decrease in osmosis pressure, which is the pressure that keeps blood fluids in the blood vessels and prevents a large loss of blood vessel fluid as it leaks into the intercellular fluid.
4. Hyperlipidemia
A rise in the level of fats in the blood is mainly represented by a rise in the level of cholesterol, and the reason for this is excessive production of cholesterol in the liver, and a decrease in the process of dismantling fats by enzymes that break down fats.
Physically, most patients with nephrotic syndrome have a decrease in blood volume, and the reaction of the kidneys in the wake of this decrease is to reduce the amount of urine secreted and fluid retention, in order to restore the blood volume to its previous condition, but due to the low osmotic pressure, a large part of these fluids escapes out blood vessels and stored as edemas.
Causes and risk factors for nephrotic syndrome
There are many causes and factors that lead to nephrotic syndrome, and they are as follows:
1. Causes of nephrotic syndrome
Among the main causes of nephrotic syndrome are the following:
Kidney diseases caused by diabetes: the most prominent of which is diabetic nephropathy, which causes damage to the glomeruli.
Mild change disease: This is the main cause of nephrotic syndrome in children, as it causes damage to kidney function, but when the cells are examined under a microscope, no problems appear.
Focal CT granulomas: scarring occurs in some glomeruli, and this disease may occur as a result of other diseases, most of which are hereditary.
Membranous nephropathy: The thickness of the glomerular membrane increases in this disease due to diseases caused by the immune system and other diseases, such as: lupus, and hepatitis.
SLE: It causes chronic inflammation that may eventually lead to kidney damage.
Amyloidosis: accumulation of amyloid in the organs, and as a result, damage to the blood purification process in the kidneys may occur.
2. Risk factors
The most important factors that increase the risk of developing nephrotic syndrome are the following:
Diseases that cause kidney damage: most notably: diabetes, amyloidosis, and reflux of the kidneys.
Some medicines: There are medicines that damage the kidneys, most notably: Non-steroidal anti-inflammatory drugs.
Some aggressive diseases: such as: AIDS, hepatitis B, hepatitis C, and malaria.
Complications of nephrotic syndrome
The common and common complications of all types of nephrotic syndrome of all kinds if left untreated are:
Blood clots due to the loss of a lot of proteins in the body.
High cholesterol and fats in the body.
Malnutrition.
Hypertension.
Bacterial and viral infections, the most important of which are: pneumonia or meningitis.
Blockages in various organs caused by elevated blood clotting factors.
Kidney failure is often seen in patients who do not respond to steroid therapy.
Diagnosis of nephrotic syndrome
The disease is diagnosed as follows:
1. Urine examination
In a urine test, the amount of protein that is purified from the kidneys and excreted in the urine is known.
2. Blood test
A blood test helps confirm the patient's kidney function, and it may detect other diseases that cause nephrotic syndrome, such as: diabetes.
3. Kidney biopsy
In some cases, a sample of kidney tissue may be taken and analyzed under a microscope.
nephrotic syndrome treatment
Usually, the causes that lead to nephrotic syndrome are treated, and the most prominent drugs used are the following:
1. High blood pressure drugs
Medicines from the group of angiotensin enzyme inhibitors, such as: Captopril, are used. This type of medicine helps lower blood pressure in addition to reducing protein excretion in the urine.
An angiotensin II receptor blocker, such as losartan, may be used.
2. Cholesterol-lowering drugs
Statins are often used to lower blood cholesterol, but the drug's effect on reducing complications from nephrotic syndrome is not known.
3. Diuretics
Diuretics help reduce fluid retention in the body, most notably furosemide and the thiazide family.
4. Blood thinners
Blood thinners help reduce the chances of clots, most notably: Heparin and Warfarin.
5. Immunosuppressive drugs
Such as: cortisone, which reduces the inflammation that leads to nephrotic syndrome.
Prevention of nephrotic syndrome
There are no ways to prevent nephrotic syndrome, but some measures may help
