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Complications of nephrotic syndrome

2017-03-01 11:43

The complication of NS is an important factor that affects the long-term prognosis of patients.

1 infection

It is usually not necessary to use antibiotics to prevent infection during hormone therapy, otherwise it will not be able to prevent the infection. Once found to be infected, should be selected in a timely manner sensitive to the pathogen, powerful and no renal toxicity of active treatment of antibiotics, there should be clear as soon as possible to remove infected foci. Severe infection is difficult to control should be considered to reduce or disable hormones, but depending on the specific circumstances of the patient.

2 complications of thrombosis and embolism

It is generally believed that when plasma albumin is lower than 20g/L (idiopathic membranous nephropathy is less than 25g/L), anticoagulant therapy may be given either heparin or low molecular weight heparin or subcutaneous injection of warfarin. At the same time can be supplemented with anticoagulant antiplatelet drugs such as aspirin, dipyridamole or oral. To have occurred thrombosis and embolism should be early (within 6 hours is best, but 3 days is still expected to be effective) treated with urokinase or streptokinase systemic or local thrombolysis, combined with anticoagulation, anticoagulation should generally be sustained application of more than half a year. Anticoagulant and thrombolytic therapy should avoid excessive bleeding.

3 acute renal failure

NS complicated with acute renal failure, such as improper handling can be life-threatening, if given in a timely manner, most patients are expected to resume. The following measures can be taken:

(1) loop diuretics remain in effect for loop diuretics should be larger dose to scour blocking renal tubule type;

(2) hemodialysis is not effective, and has reached the indications of dialysis, hemodialysis should be given to maintain life, and after the addition of plasma products to appropriate dehydration, in order to reduce renal interstitial edema;

(3) the primary treatment for the disease is mainly due to its pathological type, and it should be treated actively;

(4) alkaline urine oral sodium bicarbonate alkaline urine, in order to reduce the formation of tube type.

4 protein and fat metabolism disorders

It is often difficult to completely correct the metabolic disorder before NS remission, but the amount and structure of protein and fat in the diet should be adjusted to minimize the effects of metabolic disorders. At present, many drugs can be used to treat protein and fat metabolism disorders. Such as: ACEI and angiotensin II receptor antagonist can reduce urinary protein; studies have shown that Astragalus membranaceus can promote the synthesis of albumin in the liver, and may also reduce the role of hyperlipidemia. Lipid-lowering drugs can choose cholesterol based hydroxymethylglutaryl coenzyme A reductase (HMG-CoA) inhibitors, such as statins such as lovastatin; or triglyceride lowering mainly clofibrate, fenofibrate as such. After the remission of NS, hyperlipidemia can be naturally relieved, and no need for further treatment.

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