2014年12月23日星期二

Nephritis edema

Nephritis edema is clinically the most common symptoms, is one of the common symptoms of kidney disease. Be seen in patients with acute glomerulonephritis. This disease circulating immune complexes in the blood caused.

1. The cause of the disease

① The GFR, sodium retention

② systemic increases capillary permeability, so that the liquid is easy from the intravascular space into tissue.

③ The reduced plasma protein levels, particularly lower levels of albumin, the colloid osmotic pressure of plasma, interstitial water is easy to move.

④ Reduce effective hypovolemia, causes increases secondary aldosteronism, increased sodium retention.

2. Pathology

Nephrotic edema The central link in the pathogenesis of hypoalbuminemia and therefore the fall of colloidal osmotic pressure of the plasma, is caused by the accumulation of interstitial fluid from the primary factors. Hypoproteinemia due to plasma proteins (mainly albumin) in the urine lost much, loss of albumin per day up to 10 ~ 20 g, greatly exceeds the capacity of protein synthesis. Sodium retention and secondary water is also an important factor, which is the ball - imbalance results tube. Because hypoproteinemia colloidal osmotic pressure, increased systemic capillary leak, causing an increase in the interstitial fluid, but also caused a reduction in plasma volume and decreased effective circulating blood volume, the latter led to the renin - angiotensin - aldosterone system is activated circulating blood and activation of the hypothalamic - pituitary cause nerve ADH release increases; adh ⅱ angiotensin also caused increased secretion .These factors lead to salt and water retention, this is the proper circulating blood plasma volume and reducing the compensatory response, but the active hypoproteinemia due not eliminate edema, and sodium water retention and diluted plasma proteins, and therefore add to the liquid container, and become a source of edema fluid.

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