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Home > Learn about kidney disease > Nephrotic Syndrome

Nephrotic syndrome

NS(nephrotic syndrome), mainly showed as the increased permeability of glomerular basement membrane and the reduced GFR.

Basic

NS(nephrotic syndrome),caused by various disease etiologies,is a group of clinical syndrome.is mainly showed as the increased permeability of glomerular basement membrane and the reduced GFR.
What's NS?
NS is not an independent disease but a group of glomerular disease.The typical symptoms mainly include massive proteinuria,hypoproteinemia,HLP(hyperlipidaemia) and highly edema.
What causes NS?
The causes of NS usually are divided into 3 types:primary,secondary and congenital.Rare patients are born with congenital NS and about 90% of patients are primary NS that belongs to primary glomerular disease.Secondary NS are mainly caused by other diseases,such as SLE,henoch-schonlein purpura nephritis,DN(Diabetic Nephropathy),etc.Besides,some inflammatory response and immunoreaction both may lead to NS.
Diagnosis
diagnostic criteria
1.urine protein is greater than 3.5g/24h.
2.plasma albumin is less than 30g/L
3.edema
4.HLP(hyperlipidaemia)
(Note:the first and the third are necessary to diagnose the disease.)
Three aspects of diagnose:
1.Make a definite diagnose of NS
2.Identify the cause of disease:Exclude secondary and genetic causes firstly,then identify the primary NS.It's better to take renal biopsy to make the pathological diagnosis
3.Diagnose the complications
Prognosis
The prognosis of NS are various,which mainly depends on the following factors:
1.pathological pattern
In general,The prognoses of Minimal Change Disease and mild mesangial proliferative glomerulonephritis are better.There is a tendency to spontaneous remission in some patients with Minimal Change Disease,so the alleviation rate is higher but it is easier to be relapsing.There are a higher remission rate in early stage.Although it is can not be relieved in later stage,the disease process is slow and the occurrence of Renal Failure is rather later.In addition,the level of proteinuria and the reaction of treatment effect the prognosis badly.
2.Clinical factors
Massive proteinuria,high blood pressure and high fat may also worsen the glomerular sclerosis,which may influence prognosis.
3.Severe complications
Some patients with recurrent infections and thromboembolism may have a less-than-ideal prognosis.

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Symptoms

The most basic features of NS are massive proteinuria,hypoproteinemia,highly edema,HLP(hyperlipidaemia) and other metabolic disorders,etc.It is useful to learn some symptoms for patients to control their disease condition and improve their lives.
1.Massive proteinuria
It is the most important clinical manifestation and the most basic physiopathologic mechanism.Massive proteinuria means that the leakage of urine protein is over than 3.5g/d.When renal functions are damaged,lot of protein in initial urine can not be filtrated by glomerular filtration membrane so the protein level in in initial urine will increase even beyond the amount that the kidney tubules can resorb.Thus the lots of protein will be eliminated with the urine.In addition,some factors may worsen the leakage of proteinuria,such as high blood pressure,high protein diet,etc.
2.Hypoproteinemia
The leakage of massive proteinuria lead to the shortage of protein in blood,which promote the compensatory albumin synthesis of liver and the decomposition of renal tubules.When this kind of compensatory synthesis can not afford the loss and the decomposition of protein,with the plasma-albumin falling to < 30g/L,it is called Hypoproteinemia.What's more,other disease or complications can also deteriorate the hypoalbuminemia.
3.HLP (hyperlipidaemia)
Owing to the leakage of proteinuria,liver will produce more protein to afford the shortage.At the same time,liver may also produce some lipid.As the time and disease going on,the lipid is more and more and the damaged kidneys can not eliminate the lipid effectively.Thus hyperlipidaemia may appear.
4.Edema
With the disease process,the damage on kidneys is worse and worse.Reduced renal function can not eliminated the overmuch water and sodium in body effectively,which may causes the retention of water and sodium.In this case,edema may occur.What's worse,the level of edema will increase gradually with the anabatic disease.
These all above are the main and obvious symptoms of NS.If you or someone you love is diagnosed with NS,yo can contact with online doctor to get the professional guidance freety.

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Diet

Owing to the loss of massive protein,some symptoms are severe that worsen the NS.So it is important to offer enough protein,Besides,the edema limit the intake of water and salt.Following the diet rule is necessary for patients to control and delay the disease progressing.
1.High quality diet
Hypoproteinemia promote the liver to increase the ability of albumin synthesis.If patients are provided with enough protein and calorie in diet,it can relieve the negative nitrogen balance and improve the hypoproteinemia.The daily intake of protein is 1g/kg and add the leakage in urine.What calls for special attention is that if patients suffer from the azotemia,the amount should be limited properly.
2.limit the intake of salt and water
Due to the high edema,it is necessary to limit the intake of water,including the intake of intravenous fluids and drinking water.The intake of water should less than the patients' urine volume.Edema means that the content of sodium is overmuch than in normal,so the low salt or sodium diet is necessary.In general,the daily salt intake is 1-3g,which should allow for patients' tolerance and do not affect their appetite.
3.Low fat diet
Pay attention to the low fat diet.Due to the HLP(hyperlipemia),blood in patients' body are viscous.The intake of fat may increase the renal burden and worsen the renal damage badly.Offer the high quality protein and reduce the intake of fat,grease,etc.Furthermore,take a light diet.
4.Taboos on vegetables
For patients with NS,to eat more vegetables and fruits are beneficial to increase patients resistance.However,there are strict control and requirements to patients with NS.Some spicy and cool foods are not suitable to patients,such as spinach,pepper,bamboo shoots and so on.Besides,some foods that is rich in vegetable protein are also not improper for patients,like soybean, bean curd,etc.
Owing to the different symptoms of NS,the detailed diet taboos are different.If you are diagnosed with NS and you have other questions about your disease,you can talk to live doctor to get the specific and professional guidance freely.

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Treatments

Renal disease is one of the most difficult illnesses to cure.What's more,the the complexity and severity of NS increase the difficulty to treat it completely in modern society.Here are several common or distinctive and effective therapies to treat or control the NS.
1.General treatment
When patients suffer from severe edema or hypoproteinemia,they need to stay in bed or enough rest to relieve the symptoms.If the general conditions are better,patients can take proper exercise to increase their body resistance.To take the high-quality protein diet and limit the intake of water and salt are good for patients condition.
2.Drug therapy
Western medicine are used to treat or control the specific symptoms timely and effectively.
Various diuretic is used to reduce the edema and increase the urine output as far as possible.The decline of salt and water in body will relieve the level of edema and can also lighten the renal burden,ease the renal symptoms.Such as ACEI and ARB play an important role in controlling and reducing the renal damage.
3.Dialysis and renal transplant
In later stage in NS,The only using of drug can noy treat the renal disease and the renal damage may be worse and worse and deteriorate into ESRF.In this case,dialysis will do a lot to controlling the NS.Eliminate the overmuch water,metabolite and waste to keep the whole body system in balance.Moreover,renal transplant also are a good way to treat the NS besides its difficulty and high cost.However,as the advanced substitution therapy,there are many serious side-affects that may worsen even lead to death to patients.
4.Micro-Chinese Medicine Osmotherapy
It is a kind of TCM therapy that uses the natural herb to remedy the NS effectively.Compared with Western Medicine,it reduces many severe effects and relieve the symptoms as far as possible.What's more,it can also ease the pain and prolong the life-pan of patients largely.In addition,Micro-Chinese Medicine Osmotherapy makes big difference to controlling and delay the disease process.
Dietotherapy
Except the necessary drug therapy,keeping a healthy diet is important to limit the disease process.Control the intake of salt,water and fat and offer the high quality protein,vegetables and fruits to increase the body resistance of patients.
If you have other questions about our disease,please contact the live doctor to get the professional guidance freely.

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Healthy living

In treating the NS,except the necessary drug therapy,patients should pay more attention to their daily diet,which is helpful to their disease condition.So what should be noted in daily life of patients with NS?Here are some advice to tell you.
1.Take exercise properly
The proper exercise is good for the recovery of disease.Such as take a walk,do Tai Chi or practice qigong,etc.Moreover,the time of exercise is also need attention.It better to do some sports in the morning or at noon.Besides,swimming is a good project in summer,but it is not suitable to patients with NS.Because swimming will consume large amounts of energy and nobody can guarantee the sanitation of natatorium.So you'd better not swim in summer.
2.Lead a regular life and avoid insolation
Patients with NS should build a good living habit with conforming to the changes in the weather.Take a rest about half an hour,which can retain the strength and be good to recovery.In addition,there are some harmful ray in sunlight,like r-rays which can encroach on body easily.Many patients with NS has poor immunity,so avoid basking to worsen the disease.
3.Eat abstemiously
Vegetables and fruits are beneficial to human.However,patients with NS should follow the diet rules to avoid increasing to renal burden.For example,watermelon is good for inducing diuresis to reduce edema and heat-dispersing.But the overmuch intake of it can also increase the renal burden.Furthermore,the sugar in watermelon is a potential crisis of disease.
4.Pay attention to hygiene and sleeping environment
The bedroom of patients should be breezier ,spacious and bright,and be kept in a certain temperature to avoid catching cold.
5.Adjust emotions and promote continence
Emotional upset usually is the main reason of recurrent disease and fluctuant blood pressure.So to keep an active and optimistic mood can improve the patients condition and promote the health.
Except above notes,scientific treatments are necessary.So if you ave other questions about your disease,you can talk to online doctor to get the professional guidance freely.

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