Nephrotic syndrome is set of findings that show there is a problem with the kidneys. These findings include:
High levels of protein in urine (proteinuria).
High blood pressure (hypertension).
Low levels of the protein albumin in the blood (hypoalbuminemia).
High levels of cholesterol (hyperlipidemia) and triglycerides (hypertriglyceridemia) in the blood
Swelling of face, abdomen, arms and legs (edema).
Nephrotic syndrome occurs when the kidneys' filters (glomeruli) are damaged. Glomeruli remove toxins and waste products from the bloodstream. As a result of damaged glomeruli, essential products such as proteins may also be removed from the bloodstream. The loss of proteins and other substances the body needs causes nephrotic syndrome. Nephrotic syndrome may increase your
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Focal segmental glomerulosclerosis.
Membranous nephropathy.
Glomerulonephritis.
A condition or disease that affects other parts of the body (systemic), such as:
Diabetes.
Autoimmune diseases, such as lupus.
Amyloidosis.
Multiple myeloma.
Some types of cancers.
An infection, such as hepatitis C.
Medicines such as:
Nonsteroidal anti-inflammatory drugs (NSAIDs).
Some anticancer drugs.
In some cases, the cause of nephrotic syndrome is not known.
SYMPTOMS
You may not have noticeable symptoms. If symptoms are present, they may include:
Edema.
Foamy urine.
Unexplained weight gain.
Loss of appetite.
DIAGNOSIS
Nephrotic syndrome is usually diagnosed with dipstick urine test or a 24-hour urine collection. If your test shows that you have nephrotic syndrome, additional tests may be needed to determine its cause. These may include blood, urine, imaging, or kidney biopsy tests.
TREATMENT
You may receive medicines to treat symptoms or to prevent complications from occurring. These medicines may:
Decrease inflammation in the kidneys.
Lower blood pressure.
Lower cholesterol.
Reduce the blood's ability to
The follwong are the major kidneys tests that are performed on the patient. The first one is the glomerular filtration rate, which is performed to deduce the number of functioning nephrons, which aid in ascertaining the magnitude of kidney impairment in the individual. According to the National Kidney Foundation (2016), the glomerular filtration rate is estimated by measuring the creatinine level in the blood stream and using the results to compute the estimated GFR level. Collecting of urine samples in a 24 hour period and measuring the creatinine concentration also aid s in kidney function
Glomerulonephritis, as a defined disease, is very broad in terms of a medical condition and is usually only diagnosed after a routine medical check-up or tests for another condition discover; the symptoms may not be obvious. This disease targets the membrane tissues made of tiny filtering cluster units within the kidneys called glomerulus, which comes from a Greek word meaning filter (NIH, 2014). This illness presents as an inflammation of the tiny filtering units called glomeruli of the kidneys that can be caused by a passing illness associated with an infection or as a result of an autoimmune disease (Nemours, 1995-2016). Glomerulonephritis is a multi-symptom disease caused by genetics or environmental factors that can have variable degrees
Kidneys play an important role in the unary tract. They are located on each side of the spine, just below the ribcage. Each kidney is connected to the bladder by ureters. The kidneys have many functions, but the most common functions are to clean waste, control chemicals, and regulate fluid in the body which makes up the urine. Urine collects in the kidney before entering the ureters and as time passes more materials are added. When calcium and oxalate or phosphates are combined in the kidney tiny stones are formed called nephrolithiasis, commonly known as kidney stones. These stones can be very painful and “increases risks for diabetes, high blood pressure, and osteoporosis” (Goldfarb, 2009). About ten percent of all people will have kidney stones in their lifetime. Kidney stones are most frequently found in white men over the age of forty, relatives of kidney stone patients, and people who have formerly had kidney stones.
What is the purpose of each of the medications the patient is on? Why is this patient receiving them?
Nephrolithiasis, also known as kidney stone, affects up to 5% of the population, with a lifetime risk of passing a kidney stone of about 8-10% (Parmar 2004).
Nephrolithiasis, more commonly known as kidney stones, is a common renal disease characterized by crystal depositions in the kidney as a result of urinary supersaturation. There are several types of stones, such as uric acid, cystine, and struvite stones, but calcium stones are the most common.
1 in 3 Americans Adults are currently at risk for developing kidney disease. What is acute renal failure, when your kidneys functions all of a sudden stop working and your kidneys are the body’s filter which remove waste products and help balance water, salts and minerals especially electrolytes in your blood when your kidneys stop working you end up building all the products in your body that need to be filtered and eliminated. The pathophysiology of Acute Renal Failure are due to three main causes Pre-renal, Intra-renal, and Post renal. Pre-renal is a sudden drop in blood pressure or interruption of blood flow to the kidneys from illness or sever injury. Intra-renal is direct damage to the kidneys by inflammation of drugs, infection, toxins or reduced blood supply. Post-renal is a sudden obstruction of urine flow because of enlarged prostate bladder tumor, kidney stones, or injury.
Without proper working kidneys, blood pressure can rise, body fluids accumulate and red blood cell count can decrease. Usually kidney problems occur from disease, conditions and disorders. Disease can come from damage to nephrons, which help filter the blood. Infections can travel from the bladder up to the kidneys. Kidney cancers, kidney stones, cysts and injury all can damage a kidney. Without properly working kidneys, our heart, lungs and brain, as well as other organs are put in danger. (Capicchiano 2013) Kidney dialysis is not always a permanent need; sometimes it is needed for a short time. Kidney dialysis can occur in many places, the hospital, a home or in a center. Often people return to work after dialysis, unless their job involves strenuous activity such as heavy lifting or digging. (Lewin, 2010)
"The initial presentation of nephrolithiasis is often with renal colic - severe pain caused by stone passage - triggered by movement of a stone from the renal pelvis into the ureter, which leads to ureteral spasm and possibly obstruction" (ncbi, pg 8). Other common symptoms are severe pain in the side and back below the ribs, lower abdomen, groin and during urination. The pain occurs in waves and fluctuates in intensity. Urine will be pink, red or brown and also cloudy and smell bad. Nausea and vomiting are common as well as a constant need to
Healthy kidneys clean the blood by filtering out extra water and wastes. They also make hormones that keep your bones strong and blood healthy. When both of your kidneys fail, your body holds fluid. Your blood pressure rises. Harmful wastes build up in your body. Your body doesn't make enough red blood cells. When this happens, you need treatment to replace the work of your failed kidneys.
The case narrative that is being discussed is a patient with a PMH of chronic kidney disease (CKD) who presents to the hospital with acute kidney injury (AKI). Nephrology was consulted for evaluation and management. This case was interesting to me because of the unique cause of Nephrotic syndrome called Minimal Change Disease (MCD). MCD is a kidney disease in which large amounts of protein are lost in the urine the podcytes that are part of the glomerular filter become effaced (Up-to-date, 2017). MCD is a major cause of nephrotic syndrome in both children in and adults, in children it is often linked to a genetic defect (Up-to-date, 2017). However, in adults MCD occurs as an idiopathic or secondary condition cause by an overuse of non-steroidal anti-inflammatory drugs (NSAIDS) and selective COX-2 inhibitors (Up-to-date, 2017). It is important for primary care providers to be aware of this MCD, so that
...ering to medication antibiotics which fight off infections, bronchodialators used to decrease dyspnea relieve broncho spasms , and pulmonary rehabilitation help betters their condition. The nurse expects the patient to be able to perform suitable activities without complication, avoid irritants that can worsen the disease (contaminated air) and reduce pulmonary infection by abiding to medications.
According to the results of the tests, the patient syndrome is caused by either of the two; minimal change and focal segmental glomerulosclerosis. The pathophysiologies of the disease are primary glomerular defect and circulating permeability factor and inhibitors. The primary glomerular defect of nephrotic syndrome leads to leakage of high molecular mass proteins that’s equivalent to the size of albumin of approximately 66 kD, with haemostatic proteins of a similar size also being excreted pathologically in the urine (Eddy AA and Symons JM, 2003). Due to these excretion; prominent loss of important coagulation regulatory proteins such as antithrombin and protein S.
The kidneys are a bean-shaped organ in the human body and they have different functions and are of vital importance for it. The kidneys are the pair of organs, which are able to regulate the reabsorption of ions such as potassium, sodium and calcium, which are fundamental substances for the cell. Furthermore, they are involved in the reabsorption of nutrients in the bloodstream and they can regulate the acidity of the blood. Besides the regulation of the fluids and ions, the kidneys are also responsible for the regulation of many different hormones that are involved in homeostasis and metabolism. Because of their importance in the regulation of substances in the body, when the kidneys stop working properly all the body is influenced by that creating disequilibrium in the maintenance of homeostasi...
Secondly, they advise their patients in assuring the appropriate use of medications. It is important to tell the patient about the name of the drug, what is it for, when to take the drug, how many times per day, whether it should be taken before meals, after meals or with meals, the method of taking the drug and its side effects and possible drug-drug interactions. (Swanson, 2005)