肾病综合征诊断标准（Diagnostic criteria for nephrotic syndrome）.docVIP

肾病综合征诊断标准（Diagnostic criteria for nephrotic syndrome） Diagnostic criteria for nephrotic syndrome (1) urinary protein was greater than 3.5g/d; (2) plasma albumin was lower than 30g/L; (3) edema; (4) elevated blood lipids. Among them, (1) (2) and two items were necessary for diagnosis. [pathophysiology] A large amount of proteinuria in normal physiological conditions, the glomerular filtration membrane with a molecular barrier and charge barrier barrier effect, especially when the charge barrier damage, glomerular filtration membrane of plasma protein (with albumin based) permeability increase in protein content in urine increased, when more than the proximal tubule back to the absorption, the formation of proteinuria. On this basis, all factors that increase glomerular pressure and lead to high perfusion and high filtration, such as hypertension, high protein diet or massive infusion of plasma proteins, can increase urinary protein excretion. Two. When the plasma protein changes nephrotic syndrome, large amounts of albumin are lost from urine, which promotes the compensatory synthesis of albumin in the liver and the increase in the decomposition of the renal tubules. Hypoalbuminemia occurs when albumin synthesis increases and is insufficient to overcome loss and breakdown. In addition, patients with nephrotic syndrome due to gastrointestinal mucosal edema leading to poor appetite, insufficient protein intake, malabsorption or loss, also aggravate hypoproteinemia. Three, the edema of nephrotic syndrome, hypoalbuminemia, and plasma colloid osmotic pressure drops, so that water from the blood vessels into the interstitial tissue, is the basic cause of edema in nephrotic syndrome. Recent studies show that approximately 50% of patients with normal or increased blood volume, plasma renin levels normal or decreased, suggesting that sodium and water retention factors of some primary in the kidney play an important role in the pathogenesis of edema in nephrotic syndrome. Four