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Patient with kidney disease may have the possibility to get nephrotic syndrome, which is a severe condition for renal patient.
Nephrotic syndrome is caused by the damage in patient’s glomerular filtration membrane, which causes the increase in the permeability of patient’s glomerular filtration membrane, and patient will also have decrease in his GFR at the same time. Some kinds of kidney diseases are very likely to cause this syndrome, like FSGS, IgA nephropathy, lupus nephritis, etc.
Patient will have four obvious major symptoms, and they are massive proteinuria, hypoalbuminemia, hyperlipidemia, edema.
1.Proteinuria: Because there is severe damage in patient’s glomerular filtration membrane, which increases its permeability, and that causes massive protein to lose from patient’s blood. Proteinuria is dangerous for patient with kidney disease, because it can aggravate patient’s kidney disease obviously if it has not been well controlled.
2.Edema: patient with nephrotic syndrome can have obvious edema in his body, and that has close relationship with patient’s massive proteinuria.
3.Hypoalbuminemia: as we have said, patient with nephrotic syndrome will have massive proteinuria, and that also means there will be lots of protein losing from patient’s blood, and then cause hypoalbuminemia.
4.Hyperlipidemia: this symptom is common in patient with nephrotic syndrome, and it has close relation with the producing of lipoprotein by liver and the metabolic disorder of decomposing triglycerodes. While this symptom contributes to the formation of thrombus, and it can also promote the progression of glomerular sclerosis.
Nephrotic syndrome is divided into the primary and the secondary, so the causes of nephrotic syndrome are also divided into these two kinds.
The causes of primary nephrotic syndrome may have relation to body cell’s immune changes, the metabolic disorder of lipid, the changes of coagulation factors and massive proteinuria, etc.
The causes of secondary nephrotic syndrome will be various, and they can be divided into several types:
1. Infection: this is mainly divided into bacterial infection, virus infection, parasitic infection, and each of them can also be divided into various types.
2. Medicines, toxins and allergy: medicines like trimethadione, NSAID, probenecid, etc, and toxins like bee sting, snake venom, etc, and allergy caused by pollen, vaccine, etc, may cause people to have kidney disease that can progress into nephrotic syndrome.
3. Systemic diseases: systemic lupus erythematosus, anaphylactoid purpura, sjogren syndrome, amyloidosis, etc, can cause patient to have secondary nephrotic syndrome.
4. Metabolic diseases: like diabetes, thyroid disease, etc.
In fact, primary nephrotic syndrome is often caused by kidney disease like minimal change disease, FSGS, membranous nephropathy. And secondary nephrotic syndrome is often to be seen in diabetic nephropathy, lupus nephritis, purpura nephritis.
For the common causes of nephrotic syndrome, they have different conditions of prognosis. Minimal change disease has better prognosis, because patient’s condition can get relief easily, but it is also easy to relapse. The membranous nephropathy of early stage can have better prognosis, but it will be hard if it has progressed into the late stage. The prognosis of nephrotic syndrome caused by FSGS has close relation with the severity of his proteinuria and his reaction to hormone treatment, and patient who accept hormone treatment has much better prognosis.
Besides, hypertension, massive proteinuria and hyperlipidemia can promote the appearance of glomerular sclerosis, which should be controlled well, or else they can cause bad prognosis easily.