Tuotromedico: Syndrome nefrotico. Nefrosis

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The syndrome nefr�tico or nefrosis is a set that they appear with proteins raised in the urine and a descent of you spoil in the blood, very high cholesterol and an edema or secondary distension to this absence of proteins in to the blood.

The syndrome nefr�tico appears when for one or another cause catches fire and affects the membrane of the renal glom�rulo, faltering the leaked one and getting lost proteins for the urine.

CAUSES

In the children the most frequent cause is the illness of minimal changes, while the membranous glomerulonefritis is the most common cause in the adults.

It is possible to give this process as side effect of:

Infections

Medicines

Illnesses neopl�sicas (cancer)

Autoimmune illnesses (lupus eritematoso systemic)

Diabetes

Multiple Mieloma

Amiloidosis

In other occasions it is possible to observe in the glomerulonefritis, the glomeruloesclerosis would segment and focal and in the glomerulonefritis mesangiocapilar.

SYMPTOMS

Distension of face, eyelids, ankles or general.

Distended or puffed up abdomen.

It foams in the urine.

Weight increase for liquids retention.

Decrease of the appetite.

Arterial hypertension.

DIAGNOSIS

In the physical examination there appear the symptoms of retention of liquids as the distensions that are very typical of the loss of proteins of the vascular space.

In the urine analysis there will appear the high proteins (more than 3,5 grams per day), and the presence of cylinders hialinos.

Also there will turn out to be raised in blood the cholesterol and the triglic�ridos.

With it the proper syndrome is diagnosed nefr�tico and then diverse studies are realized to find out the causes:

Antinuclear antibodies (ANN).

Rheumatoid factor.

Crioglobulinas.

Tolerance test to the glucose (curve of glycemia).

Levels of the complement and fractions.

Antibodies for hepatitis B and C.

Serolog�a for VDRL (syphilis).

Protein Electroforesis in whey.

Biopsy of the kidney.

TREATMENT

To improve the picture and to stop the renal deterioration it is necessary to treat the causes.
According to the diagnosis of the same it is possible to give corticosteroides, inmunodepresores, antihypertensive, diuretics, in addition to there associates the inhibiting ones of the enzyme convertidora of angiotensina (ECA) that can reduce significantly the grade of loss of protein in the urine.

Medicines usually collaborate to reduce the cholesterol and the triglic�ridos.

Anticoagulants can happen if there is seen risk of formation of clots by the underlying illness.
Also there is recommended a diet moderated in proteins (1 gm of protein per kilogram of corporal weight a day).

The sodium of the salt must be restricted to help in the control of the inflammation.
It is possible that it is necessary to replace the vitamin D if the syndrome nefr�tico is chronic and does not answer to the treatment.

The picture can be sharp and yield in the brief space of time as in infectious pictures, but in other cases it becomes chronic and a treatment is needed of by life.

COMPLICATIONS

Sharp renal insufficiency

Chronic renal insufficiency

Ateroesclerosis and cardiopat�as connected

Renal venous thrombosis

Infections

Undernourishment

Surcharge of liquids, congestive heart failure, pulmonary edema

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