Signs and symptoms of children with primary nephrotic syndrome

Signs and symptoms of children with primary nephrotic syndrome

The diagnosis of nephrotic syndrome according to the clinical manifestation, there is a lot of proteinuria (24 h urine protein quantitative > 0.1 g/kg, or > 3.5 g/kg), height edema, hypercholesterolemia (> 5.7 tendency for L, < 220 mg %), low serum albumin leels (< 30 g/L, < 3 gg %) can be diagnosed as nephrotic syndrome, typical cases of serum protein electrophoresis hint alpha 2 write write, and gamma left, part of the sick children can have low complement, the microscopic or gross hematuria, nitrogen qualitative hematic disease or hypertension, children of pre-school age > 1610.6 kPa (120/80 MMHG), school age > 17.3/12 kPa (130/90 MMHG), is a kidney disease, nephritis sex to hormone drug resistant (8 weeks enough hormones is invalid or has some effects), frequent recurrence or relapse (close in 2 or more times, one year 3 times or more) and hormone dependent on kidney disease, known as the persistent nephrotic syndrome, persistent nephrotic syndrome is one of the renal biopsy indications, to clear its pathological classification, kidney disease severity to guide treatment, has high coagulation state of children with prothrombin time shortened, plasma fibrinogen levels, platelet count is higher than normal, hormone therapy, but according to the facts of flank pain with hematuria, blood pressure, edema aggravated or deterioration of renal function and renal vein thrombosis, in addition, the analysis of the primary disease treatment, including a large number of proteinuria and low serum albumin leels prerequisite for diagnosis.


Onset age and gender, and preschool for peaks, herpes onset age small, tight 腅 slightly long, more men than women, male: female is about 1.5 ~ 3.7:1.


Edema were the most common clinical manifestations, and often the earliest discovered by parents, beginning from the eyelids, face, gradually, and the whole body, limbs edema concave, to be fair as a serous cavity effusion hydrothorax and ascites, boys often have significant scrotal edema, weight can increase 30% ~ 50%, children with severe edema in the thighs and the upper arm medial and abdominal wall skin visible stretch marks or purple lines, edema extent usually has nothing to do with the prognosis, edema, and always have reduced the volume of urine.
Except edema patients can long-term protein loss in protein malnutrition, expression is pale, dry skin, yellow hair dry. It refers to the nails appear white horizontal grain, auricular cartilage is weak, and the nasal children with depression, fatigue weakness, loss of appetite, diarrhea, sometimes may be associated with intestinal mucosal edema and/or associated with infection, disease period long or repeated attacks the author development lags behind, nephritis sex children can have higher blood pressure and blood in the urine.
1. Nephrotic syndrome diagnostic criteria
(1) a large amount of proteinuria, urine protein ~ for more than two weeks, the 24 h urine protein quantitative is greater than 0.1 g/kg.
(2) hypoalbuminemia, plasma albumin less than 30 g/L.
(3) the hypercholesterolemia: cholesterol is greater than 5.7 tendency/L (220 mg/dl).
(4) edema: edema can be light to heavy, a lot of proteinuria and hypoalbuminemia is essential.
2. Nephritis sex nephrotic syndrome diagnostic criteria With nephrotic syndrome based on four big features, is one of the following four or more of the nephrotic syndrome can be diagnosed nephritis sex.
(1) blood in the urine, urine red blood cells, more than 10 / Hp (scattered in 2 weeks 3 or more times a centrifugal check).
(2) continuous or recurrent hypertension: preschool children more than 16.0/10.6 kPa (120/80 MMHG), school-age children more than 17.33/12.0 kPa (130/90 MMHG), and ruled out due to adrenal cortical hormone.
(3) continuous nitrogen qualitative hematic disease, urea nitrogen (BUN) more than 10.7 tendency for L (30 mg/dl), and ruled out due to insufficient blood volume.
(4) the amount of total serum complement (CH50) or C3 continuous or repeated lowering.