What is the reason for the high degree of edema of nephrotic syndrome?

In clinical practice, often can see many patients with nephrotic syndrome, swelling of the phenomenon of serious. Why is this?

According to hospital experts, nephrotic syndrome, the reasons for the high degree of edema is mainly affected by two aspects:

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    (1) decreased plasma colloid osmotic pressure: the exchange of blood vessels inside and outside the body by its osmotic pressure on both sides of the regulation. Osmotic pressure, including osmotic pressure and colloid osmotic pressure, the former from the crystal material (mainly electrolyte), because it is free to pass through the capillary wall, so the internal and external blood vessels within the exchange of little effect; the latter mainly from the protein (which is mainly Albumin), because it is not free through the capillary wall, which is the main factor in the exchange of blood vessels inside and outside the main factors. 

Nephrotic syndrome, due to a large number of plasma protein loss from the urine, causing hypoproteinemia, resulting in decreased plasma colloid osmotic pressure, when the normal 3.3 ~ 4kPa down to 0.8 ~ 1.1kPa, the blood vessels Water to hypertonic interstitial fluid movement, and edema occurred.

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    (2) reduced effective blood volume: the removal of plasma water to reduce the effective blood volume, which led to the following changes in the body: through the capacity of the sensor to increase antidiuretic hormone (ADH), renal tubular reabsorption of water increased; Su - angiotensin - aldosterone system, resulting in secondary aldosteronism, renal tubular reabsorption of sodium increased; inhibition of natriuretic factor production, the kidney to reduce sodium. So the body of water, sodium retention, further aggravated edema. The above two factors together cause a high degree of edema of nephrotic syndrome.

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The cause of nephrotic syndrome

Can cause a lot of causes of nephrotic syndrome, summed up can be divided into primary and secondary two categories.

First, the primary factor(The cause of primary NS is not clear, but with the following factors)

(A) genetic factorsChildren with nephrotic syndrome in the prevalence of compatriots and twins accounted for about 2% -6%. It may increase the sensitivity of the pathogenesis of minor lesions.

 (B) - allergic body qualityIto studied the HLA antigens of various kidney diseases in children, indicating that NS had 35.3% of allergic factors and 6.7% in the control group, which was related to HLA-B40. There have been reports of NS metamorphosis history accounted for 40%. 

(C) immune mechanisms

NS is associated with humoral immunity, immune complex formation, and cellular immunity. Elzouki (Ai Luke 1984) survey report, Arabian children with primary nephrotic syndromeThe incidence rate of 11.6 a few. Million children. 

The higher incidence of the disease may be related to climate, geography, the type of child infection, the genetic characteristics of the Arab population, many factors may affect the immune pathogenesis of kidney disease.Second, secondary factors

 (A) infection

1, bacterial infection: streptococcal infection after nephritis, bacterial endocarditis, shunt nephritis, syphilis, leprosy, chronic pyelonephritis with reflux nephritis.

2. Viral infection; hepatitis B, infectious mononucleosis, Cy-tomegalovirus, post-vaccine nephritis.

3. Parasitic infections: three malaria, Toxoplasnosis, Helminthic (sehistoso-miasis).

(B) drugs

Poisoning, allergic, organic or inorganic mercury, organic gold, bismuth, silver, penicillamine, heroin, probenecid, trimethophenone, Captopril, bee sting, snake venom, pollers, antitoxin or vaccine allergy.

(C) new creatures

Solid tumor (Careinoma or sarcoma): lung, colon, stomach, breast, kidney, thyroid, ovarian and other tumors, wilm's tumor.

Lymphoma and leukemia, Hodgkin's disease, non-Hodgkin's lymphoma, chronic lymphocytic leukemia, multiple myeloma.

(D) Department of 6L disease

Systemic lupus erythematosus, mixed connective tissue disease, Sjogren's syndrome, rheumatoid arthritis, allergic purpura, necrotizing vasculitis, polyarteritis, cryoglobulinemia, amyloidosis, sarcoidosis.

E) metabolic diseases

Diabetes, mucus edema.

(F) hereditary disease

Alport, Syndrome, Fabry's Disease, Nail-patella Syndrome, Congenital Nephrotic Syndrome (Finnish), familial nephrotic syndrome, sickle red blood cell anemia.

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