Patient's question:
Patients with nephrotic syndrome often sweat easily, have right lower rib pain, and abdominal distension pain. What is the reason?Doctor's answer:
1. Simple primary nephrotic syndrome is most common in children and adolescents. The male-to-female ratio is approximately 2:1.(1) Pitting edema is present throughout the body, most notably in the face, lower limbs, and scrotum. Ascites is often present, and the general condition is usually good without hypertension.
(2) Urine output is decreased, with proteinuria typically ranging from ++ to ++++, with a quantification >0.1g/(kg·d). Occasional red blood cells may be observed in urine microscopy.
(3) Total plasma protein is below normal, with a more significant reduction in albumin (<30g/L). Serum protein electrophoresis shows a decreased proportion of albumin and an increased proportion of globulins, with a reduction in α?-globulin. Blood cholesterol is significantly elevated (>5.7mmol/L), and serum complement levels are normal.
(4) Renal function is generally normal, but during the edema phase with significant oliguria, transient mild azotemia may occur.
2. Nephrotic syndrome with renal inflammation is most commonly diagnosed in school-aged children. The clinical features are as follows:
(1) The condition is more common in children over 7 years old, with generally mild edema.
(2) Blood pressure may be elevated to varying degrees, often with episodic or persistent hypertension and hematuria.
(3) Serum complement levels may be reduced, and varying degrees of azotemia may be present.
3. Congenital nephrotic syndrome is rare and is usually an autosomal recessive genetic disorder. It is most commonly diagnosed in neonates or within the first three months of life, with symptoms similar to simple nephrotic syndrome.