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What are the main clinical manifestations of nephrotic syndr

Deep vein thrombosis of lower extremity: the most common is sudden swelling of one limb, only local distending pain in light person, aggravated symptoms in standing, obvious local pain in heavy cases and difficulty in walking. Physical exam...

What are the main clinical manifestations of nephrotic syndr

Feb 16, 2018 by Kidney Disease Expert

Deep vein thrombosis of lower extremity: the most common is sudden swelling of one limb, only local distending pain in light person, aggravated symptoms in standing, obvious local pain in heavy cases and difficulty in walking. Physical examination shows asymmetric edema of both lower extremities, tenderness in deep vein area, Superficial varicose veins, chronic thrombosis can be seen in skin stiffness and pigmentation.

Renal vein thrombosis: According to the forming time of renal vein thrombosis, it can be pided into two types, acute and chronic, the manifestations of which are different, nephrotic syndrome complicated with renal vein thrombosis is more common. Acute renal vein thrombosis showed symptoms of renal infarction, such as low back pain, lateral abdominal pain (which can be colic) and gross hematuria. Concurrent acute renal vein thrombosis, urine protein can be increased, renal dysfunction. Imaging examination revealed a significant increase in the kidneys, usually within 1-2 days, up to a maximum volume within a week.

Bilateral renal vein thrombosis may occur oliguria and acute renal failure. Chronic renal venous occult often occurs, most patients without obvious symptoms, often found in clinical screening. Clinical proteinuria often does not alleviate or increase may be associated with microscopic hematuria, and sometimes may have renal dysfunction such as elevated serum creatinine, renal tubular dysfunction. Such as collateral circulation to establish a good renal reflow improved renal function can be no significant effect.

Pulmonary Embolism: Chest pain, hemoptysis, and dyspnea are considered triad of pulmonary embolism, but the incidence of pulmonary embolism with this triad is not high at the same time. The most common symptoms of pulmonary embolism is dyspnea, often with asphyxia, and difficult to explain for other reasons, in particular, patients with mild dyspnea should not be overlooked. The incidence of chest pain is also high, with pleural pain is more common, sometimes radiating to the neck and shoulders, may be accompanied by sweating.

Hemoptysis suggests that the symptoms of pulmonary infarction occur mostly within 24 hours after pulmonary infarction, mainly due to compensatory expansion and rupture of the bronchial submucosal bronchial artery after pulmonary hypertension, usually with bright red color and small amount of bleeding. Syncope is often due to severe pulmonary embolism caused by insufficient blood supply to the brain, may be the earliest or the only symptoms of pulmonary embolism.

It is not difficult to diagnose typical thrombotic complications in nephrotic syndrome, but the clinical manifestations are often atypical. Therefore, clinicians and patients must be on high alert and observe the changes of the disease. Membranous nephropathy, albumin levels (albumin nephropathy albumin <28g / L, non-membranous nephrotic nephrotic syndrome patients <20g / L) is a clear sign of nephrotic syndrome complicated by thrombosis.

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