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Do you know "three high and one low" kidney disease?

Nephrotic syndrome (NS) is a group of glomerular diseases with "three high and one low" clinical manifestations caused by different etiology and multiple pathological changes, including:
1. High proteinuria (> 3.5g / d)
2. highly edema
3. Hyperlipidemia
4. Hypoproteinemia (plasma albumin less than 30g / L)
Among them, the first and fourth are also necessary for the diagnosis of nephrotic syndrome standards. The disease is more common in male, especially the incidence is higher in children, but the incidence of adults is lower, however, after 60 years of age, the incidence has a small peak. The disease is pided into primary and secondary. Primary nephrotic syndrome is the most common cause of acute and chronic glomerulonephritis; secondary nephrotic syndrome can occur in diabetic nephropathy, lupus nephritis, drug nephropathy and other secondary glomerulonephritis.
Nutritional metabolic characteristics
1. protein deficiency
In normal physiological conditions, the glomerular filtration membrane has the role of molecular barrier and charge barrier, The impairment of these barriers results in an increase in the protein content in the urine and a large amount of proteinuria when the amount of reabsorption increases significantly more than that of the proximal convoluted tubule. Renal tubular decomposition of albumin capacity enhancement, normal liver synthesis of albumin 10% in the renal tubular metabolism, nephrotic syndrome can be increased to 16 to 30%; when the amount of liver protein synthesis to overcome the loss and decomposition, there will be hypoproteinemia, patients often have negative nitrogen balance, pediatric patients may affect growth and development.
2.Lipid metabolism disorders
Nephrotic syndrome, lipid metabolism is characterized by hyperlipidemia, and can continue to exist after the disease enter into the recovery period. Mainly because of hypoproteinemia can promote the synthesis of protein in the liver, while stimulating the liver to increase cholesterol and lipoprotein production, and lipid clearance disorders, so that the adipose tissue stored in the non-esterified fatty acids transferred to the liver, induced hyperlipidemia. Therefore, in this case, low-fat diet and can not significantly reduce blood lipid levels.
3. Edema
Hypoglycemia caused by decreased plasma colloid osmotic pressure, water from the vascular lumen into the tissue gap, resulting in reduced blood volume, renin - angiotensin - aldosterone system activation, increased antidiuretic hormone secretion, leading to renal tubular reabsorption of sodium Increase, cause edema. Patients with nephrotic syndrome may have hypokalemia or hyperkalemia.

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