1 、 secondary nephrotic syndrome Secondary nephrotic syndrome is caused by a variety of causes, including diabetic nephropathy, renal amyloidosis, systemic lupus erythematosus, nephritis, new organisms, and nephrotic syndrome caused by infection. In gener...
1 、 secondary nephrotic syndrome
Secondary nephrotic syndrome is caused by a variety of causes, including diabetic nephropathy, renal amyloidosis, systemic lupus erythematosus, nephritis, new organisms, and nephrotic syndrome caused by infection. In general, children should focus on excluding diseases and allergic purpura, hereditary infection secondary nephrotic syndrome in youth, it should focus on exception of connective tissue disease, infection, drug induced secondary nephrotic syndrome; elderly should consider kidney metabolic diseases and new bio related syndrome.
2. Primary nephrotic syndrome
Most of the children and adults about 2/3 for primary nephrotic syndrome, including primary glomerulonephritis, chronic glomerulonephritis and rapidly progressive glomerulonephritis. The pathological types of primary nephrotic syndrome also has a variety of, with minimal change nephropathy, mesangial proliferative nephritis, membranous nephropathy, mesangiocapillary glomerulonephritis and focal glomerular sclerosis phase 5 clinical - pathological type is most common. Among them, children and adolescents with small lesion nephropathy are more common; middle-aged with membranous type of disease is common.
Both primary nephrotic syndrome (PNS) or secondary nephrotic syndrome all have the same pathological changes, clinical manifestations and metabolic changes.
PNS: it is proved that the pathogenesis of immune mediated inflammation and mediated glomerular injury in the pathogenesis of PNS, the first in China to report PNS patients with soluble interleukin 2 receptor (SIL 2R), tumor necrosis factor alpha (TNF alpha), platelet activating factor (PAF) and abnormally elevated lymphocyte subsets abnormalities mononuclear cell infiltration, giant saliva, proliferating cell nuclear antigen (PCNA) expression increased, antioxidant function loss and other performance.
Changes in permeability of the glomerular basement membrane are the underlying cause of proteinuria in nephrotic syndrome, including changes in the charge barrier and pore size barrier. The ability of renal tubular epithelial cells to re absorb proteins in urine and their catabolism has a certain influence on the formation of proteinuria. The main component is albumin, which also includes other plasma components. It is related to the selectivity of urinary proteins, and the degree of urinary proteins varies greatly among inpiduals. The amount of urinary protein excretion was affected by glomerular filtration rate (GFR), plasma albumin concentration and protein intake.
In addition, low urine and severe hematuria can increase urinary protein, which is due to the release of hemoglobin from erythrocytes. In clinical, the urinary protein of nephrotic syndrome should be accurately quantified to observe the therapeutic effect.
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