Diagnosed with nephrotic syndrome which indicators need to see?

1, massive proteinuria.A large amount of proteinuria is a sign of nephrotic syndrome.Main component is albumin, plasma protein can also contain other components.Glomerular basement membrane permeability change is the basic cause of proteinuria, mechanical barrier and charge barrier changes (glomerular capillary pore size screen), renal tubular epithelial cell absorption and catabolism of ability also have influence on the formation of proteinuria.Glomerular filtration rate, concentration of plasma protein and protein intake directly affects the degree of proteinuria.Glomerular filtration rate falls, proteinuria decrease;Severe hypoalbuminemia, urine protein excretion quantity can increase, high-protein diet can increase urine protein excretion;Only with daily protein quantitative method, therefore, cannot be accurately judge the degree of urine protein, albumin can further do clearance, urinary albumin/creatinine (> 3. 5 is often nephrotic range proteinuria).Urine protein electrophoresis detection components in urine IgG prompt selectivity lower urinary protein.The clinical value of urine protein was no sure, has been to use less.

2, edema.Gradually increasing anasarca, is one of the most notable symptoms.The initial morning eyelid, facial, visible ankle edema;Edema development as the illness spread to the whole body, and pleural effusion, ascites, pericardial effusion, mediastinal effusion, scrotal edema or labia, also can appear pulmonary edema.Severe cases can't open my eyes, head and neck coarsens, skin can show waxy pallor, together with the chest, the presence of ascites, so the apparent difficulty breathing, cannot lay down only sitting position.If any skin damage, the tissue fluid overflow and not easy to stop.Edema and the position relations, such as there has nothing to do with the position of edema, should be suspected and venous thrombosis.The severity of edema generally and the degree of low serum albumin leels were positively correlated.General edema was thought to be mainly caused by a large amount of proteinuria plasma proteins (especially albumin), plasma colloid osmotic pressure to reduce, intravascular water gap caused by moving to the organization.Otherwise think eigen edema associated with primary renal sodium water retention, possible factors are: (1) the glomerular filtration rate decline;(2) renal tubular reabsorption increase;(3) distal tubule of plasma atrial peptide (ANP) reaction ability.

3, hyperlipidemia.This three acyl glycerin increased significantly, total cholesterol, low density lipoprotein (LDH), low density lipoprotein (VLDH) levels.Hyperlipidemia is associated with low serum albumin leels, LDL/HLDL only in serum albumin below 10 ~ 20 g/L to rise.High-density lipoprotein (HDL) normal or decline.LDL/HDL ratio increases, increased the risk of arteriosclerosis sex complications, hyperlipidemia associated with thrombosis and progressive glomerular sclerosis.Patients can show lipid urine, urine has the double refraction fat body, for it contains cholesterol or fat body tube type of epithelial cells.

4, hypoalbuminemia.Serum albumin less than 30 g/L.Nephrotic syndrome in the liver to increase albumin synthesis, when give enough protein and calorie diet, in patients with liver albumin synthesis about 22 every day.6 g, 15 every day than normal.6 g significantly increased.When liver albumin compensatory effect is not enough to compensate for the loss of urine protein quantity, will appear hypoalbuminemia.Between hypoalbuminemia and urinary protein excretion is not fully consistent.Negative nitrogen balance nephrotic syndrome patients often, when high protein load, to be converted into positive nitrogen balance, high protein load may be made by increase glomerular filtration protein urine protein excretion increased, so the higher plasma protein is not obvious, but at the same time taking blood converting enzyme inhibition, can obstruct urinary protein excretion, blood albumin concentrations can obviously increase.It is worth noting, hypoalbuminemia, the combination of drugs and albumin will be reduced, free drug concentration in blood increases, may increase the drug toxicity reaction.
Nephrotic syndrome with a variety of plasma protein composition can change, alpha and beta globulin increased 2, alpha 1) more than normal.IgG levels significantly decreased, while the IgA, IgM, IgE levels more than normal or elevated, fibrinogen and blood coagulation factor Ⅴ, Ⅶ, Ⅷ, Ⅹ can rise, may be associated with elevated liver synthesis, with increased platelet number, antithrombin Ⅲ (heparin on factor) is reduced, protein C and S protein concentration more than normal or increased, but the activity decline.This will help high coagulation state.Urine in the increase of fibrin degradation products (FDP), reflects the changes of glomerular permeability.In short, blood coagulation and agglutination of various factor are increased, and the mechanism of coagulation and fibrinolytic function damage.Due to high cholesterol and high blood fibrinogen joint effect of the plasma viscous degree increase, when vascular endothelial damage, easy to produce spontaneous thrombosis.

In addition, transporters, such as carrying important metal ions (copper, iron, zinc) protein decreased, and the important hormone (thyroid hormone, cortisol, prostaglandins) and active 25 - (OH) D3 protein also decreased, which can result in secondary hyperparathyroidism, calcium phosphorus metabolism disorder, cause renal bone disease.Continuous transferrin decreased, glucocorticoid in the weakened free and combination of hormones in the human body ratio change, led to the drug metabolism and curative effect change.