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Pediatric nephrotic syndrome common complications

2017-07-01 10:34

Nephrotic syndrome (NS) can be caused by a variety of causes, increased glomerular basement membrane permeability, manifested as a large number of proteinuria, hypoproteinemia, highly edema, hyperlipidemia, a group of clinical syndrome.

1, infection

Is the most common cause of complications.

Susceptibility causes: IgG and complement components are lost in urine, IgG synthesis down to immune dysfunction; cellular immune dysfunction; protein malnutrition; edema; immunosuppressive agents. Respiratory tract infection is the most common, followed by skin, urinary tract infections and primary peritonitis. Peritonitis is common in children with ascites, pathogens to capsules (such as Streptococcus pneumoniae) and E. coli is more common, clinical manifestations of fever, abdominal pain and abdominal distension, abdominal muscle tension and rebound tenderness is not significant.

2, electrolyte imbalance

Hyponatremia: long-term ban salt, excessive use of diuretics, infection (increased stress antidiuretic hormone secretion), diarrhea, vomiting caused by anorexia, fatigue, lazy, lethargy, blood pressure, shock, convulsions The

Hypokalemia: diuretics or hormone diuretic, anorexia, vomiting and diarrhea caused by neglect of potassium. Hypocalcemia and osteoporosis: vitamin D binding protein lost from the urine, D levels decreased, intestinal calcium absorption, bone sensitivity to parathyroid hormone regulation, hyperparathyroidism, etc., with hormones Of the application.

3, hypercoagulable state, thrombosis

Causes: liver synthesis of coagulation factors increased; urinary loss of anticoagulant factor III; hyperlipidemia blood viscosity, slow blood flow, platelet aggregation increased; infection or vascular wall injury activation of endogenous coagulation system; diuretics, Blood volume reduction, blood concentration; hormone application to promote high coagulation and so on.

Renal venous thrombosis is the most common: sudden low back pain or abdominal pain, non-glomerular hematuria, oliguria, and even acute renal failure, B-visible side or bilateral kidney increases, large blood vessels can see the thrombus. In recent years reported pulmonary embolism is not uncommon, but also lower extremity thrombosis, cerebral embolism reported.

4, adrenal crisis

Long-term use of larger doses of hormones, pituitary - adrenal cortex axis by inhibition, such as withdrawal too fast, sudden interruption of medication, the occurrence of stress and not timely increase, etc., children can suddenly appear shock performance, if not timely treatment To die.

5, acute renal failure

The possible causes are: hypovolemia induced renal failure; glomerular lesions serious, hyperplasia significantly, GFR decreased significantly; severe interstitial edema, tubule blocking renal tubular proximal tubules and renal small Intracavitary hydrostatic pressure increased, resulting in effective reduction of glomerular filtration and so on.

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