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How to differentiate and judge nephrotic syndrome?

Written by admin | Published on 2017-10-23


Nephrotic syndrome is a group of clinically similar symptoms, rather than an independent disease. Summarized can be pided into two categories: primary and secondary. Primary and secondary nephrotic syndrome, although there is a common clinical manifestations, but there are great differences in etiology, pathogenesis and treatment. Therefore, the two must be further differential diagnosis.

Primary nephrotic syndrome

It is caused by primary glomerular diseases, such as minimal change nephropathy, membranous nephropathy, membranous proliferative nephropathy, mesangial proliferative glomerulonephritis, focal segmental glomerulosclerosis, etc.. Small lesions of kidney disease, more common in children and adolescents. Onset concealed, naked hematuria Membrane nephropathy, the general incidence of 35 years of age, the onset of occult, slow development of the disease, prone to renal vein thrombosis, gross hematuria rare. Membrane proliferative nephropathy, frequently before the age of 30, acute onset, almost all patients have microscopic hematuria, renal function was progressive decline, about 1/3 of patients with high blood pressure. Mesangial proliferative glomerulonephritis, occur in young people, occult onset, but also acute attack, accompanied by hematuria, microscopic hematuria-based, and mild to moderate hypertension. Focal segmental glomerulosclerosis, more common in young people, most patients are almost hidden disease, the most performance is nephrotic syndrome, followed by microscopic hematuria, renal dysfunction.

Secondary nephrotic syndrome

There are many causes of secondary nephrotic syndrome, such as systemic diseases, metabolic diseases, allergic diseases, infectious diseases, nephrotoxic substances, malignancies, hereditary diseases, pregnancy toxemia and chronic rejection of renal transplantation and many more. But there are only a few common clinical, such as systemic lupus erythematosus, kidney, diabetic nephropathy, renal amyloidosis, Henoch Schonlein purpura nephritis and so on.

Systemic lupus erythematosus nephropathy is common in young women, often manifested as multiple tube damage, blood can be found in lupus erythematosus cells, plasma globulin was significantly increased. Diabetic nephropathy occurs in patients with longer history of diabetes, diabetic retinopathy, and kidney damage is often parallel. Renal amyloidosis occurs mainly in middle-aged men and women, often have chronic inflammation or chronic suppurative disease lesions. Purpura nephritis mostly in adolescents, the incidence and respiratory infections, can be more common in winter, hematuria is the most common clinical manifestations of allergic purpura kidney damage.

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