Origin and diagnosis of nephrotic syndrome2017-06-11 09:54
Christian (Christiansen) in 1932 with nephrotic syndrome (nephroticsyn drome nephrotic syndrome) the term, due to a variety of generalized renal damage in severe proteinuria, and a corresponding set of clinical manifestations, the root and nephropathy similar named nephrotic syndrome. The basic feature of this syndrome is proteinuria. "A lot of" proteinuria is one line for the history of various countries and hospitals have different boundaries, at present our country's definition of no less than 3.5G / d. Most of the foreign is more than 3G (or 3.5G) /1.73m2./d. Often accompanied by hypoproteinemia (less than 30g), edema, hyperlipidemia.
Although nephrotic syndrome as a set of clinical syndromes has a common clinical manifestation, disease, Yin, physiological and metabolic changes, and even treatment, there is a common law. However, because it is a group of syndromes caused by various etiologies, pathologies and clinical diseases, it has its own characteristics in clinical manifestations, pathogenesis and treatment. Nephrotic syndrome, like fever and lean straight, should not be used as the final diagnosis of disease.
There are different views on the use of Pediatrics in nephrotic syndrome. Nephrotic syndrome is a clinical condition in which the permeability of the glomerulus is increased for a variety of reasons, resulting in the loss of large amounts of protein from the urine. Has the following characteristics: clinical proteinuria (qualitative + + + or more quantitative for children more than o. 1g / kg, d) hypoproteinemia (serum albumin, child <30g/L, infant <25g/L), hypercholesterolemia (serum cholesterol, child > 5). 70mmol / L, baby >5. 20mmol / L and marked edema are common features of clinical eO syndrome. The first of these four is the prerequisite. Nephrotic syndrome is more common in pediatric kidney disease, second only to the most common acute glomerulonephritis and urinary tract infections. According to the national pediatric kidney disease research group (1986) in six administrative areas in China 20 provinces, municipalities and counties in 105 hospitals in 1982 pediatric urologic disease inpatient pediatric urinary system disease, Diabetes Hospital at the same time the total number of 2.63%, nephrotic syndrome accounted for 21% of urinary tract diseases, after acute nephritis (53%). Beijing Children's Hospital (1988) for 30 years (1956~1985) in the hospital internal medicine urinary diseases hospitalized case analysis, and the results of these investigations approximate, the primary nephrotic syndrome accounted for 19. 02%. And there is a trend of increasing year by year. The first hospital of Beijing Medical University, pediatrics, 1967~1976, 10 years of hospitalization in children under 14 years of age, nephrotic syndrome accounted for 38 of the total number of kidney disease. 1%. In children over 1 years of age, primary glomerular disease with nephrotic syndrome accounts for about 90% of the nephrotic syndrome, and is higher than the adult proportion.
Nephrotic syndrome is a common manifestation of glomerulopathy (including glomerulonephritis, nephropathy, lupus, and others), but it should also be noted that many glomerular diseases do not show this.