Definition and causes
A syndrome is a collection of symptoms. Nefrotisk syndrome occurs in the kidney and is defined by:
- High protein in the urine (Proteinuria).
- Low concentrations of albumen in the blood (Hypoalbuminæmi).
- Fluid retention in the skin (Ødemer)
Nyrerne become popular said leaking, resulting in a significant loss of proteins that leaks occur from the blood to the urine. The loss of proteins, particularly the albumen, make some of the fluid can not be kept in the bloodstream but instead pulled out in the tissue, including is the cause of ødemerne.
Nefrotisk syndrome seen most often in children and occurs most often in 1 to 4 years of age. In 70 to 80% of cases, you will find no cause of the syndrome. Nefrotisk syndrome can be seen by diseases such as Glomerulonephritis and Henoch-Schönleins purpura .
Nefrotisk syndrome is rare (2 of 100,000 per. Years) and is twice as frequently in boys as for girls.
Symptoms of nephrotic syndrome
The most common symptoms include:
- Ødemer(fluid retention in the skin): Spend typically as a swelling and konsistensændring of the skin, which becomes more spongy and less elastic. Ødemerne starts around the eyes, but may later spread to other parts of the body. Does the child up, seen ødemerne most on the feet, ankles and underben. Is the child most, collected ødemet in flankerne. We can explore for oedema by pressing the skin those places with a finger. By oedema finger will leave a dent in the skin, which will be standing for a while. Theypitting (recess = pit).Ødemerne can also be pronounced in Billfold or skamlæberne.
- Vægtøgning: Is fluid retention in the body.
- Almensymptomer: The most common are severe tiredness and loss of appetite.
- Little urinproduktion (oliguria).
- Proteinuria: The great separation of æggehvidestoffer in the urine can do that skummer much of urination.
- Infektionstendens: Is the loss of immune antibodies in urine.
- The liquid can also come out in the thoracic cavity (hydrothorax) Or the abdominal cavity (ascites). In a large accumulation of fluid in the chest can cause shortness of breath, because the lungs can not be folded completely out when the weather is drawn into. Væskeansamling in both breast as abdominal cavity increases the risk of infection with the bacteria.
Precautions and diagnosis
If your child develops symptoms of nephrotic syndrome, one should consult a doctor for the purpose of diagnosis and treatment. The diagnosis made on the medical history and examination of the child. Urine from a full day collected and examined, in order to determine the quantity of protein and measure renal function.
The suspect glomerulonefritis blood sampling, which examines the various antibodies. It only takes a vævsprøve (nyrebiopsi), if there are symptoms of nephritis , Or if it has been ineffective in over 4 weeks. Vævsprøven examined microscopically with a view to making the diagnosis glomerulonefritis .
Consideration of nephrotic syndrome
The treatment is medical and may consist of several different medicines. The cornerstone of treatment is binyrebarkhormon, which is given for 12 weeks and works by inhibiting the immune system. The symptoms can be treated with vanddrivende medicines and drugs against high blood pressure.
If there is infection in the kidneys, caused by bacteria and treated with antibiotics after detailed studies, which depends on the infection in question.
By nephrotic syndrome triggered by certain types of Glomerulonephritis binyrebarkhormon is inadequate and the treatment must be complemented by chemotherapy.
Select and complications
Nefrotisk syndrome have a strong tendency to return. 70% with a history of nephrotic syndrome, will have it again. If there is an operative reason, the prognosis good, even if the disease reappears. If nephrotic syndrome triggered by Glomerulonephritis or Henoch-Schönleins purpura , There is a risk for the development of chronic renal failure.