The nephrotic syndrome (NS) is a group consisting of a variety of causes clinical symptoms. It is accompanied by increased permeability of the GBM and decreased glomerular filtration rate predominant glomerular injury syndrome. The most basic peculiar feature of nephrotic syndrome is many proteinuria, hypoproteinemia, the degree of edema is high and hyperlipidemia, called "three high and one low."
1. Many proteinuria.
Many proteinurias are most important clinical behavior of patients with NS, are also more basic pathophysiological mechanisms of nephrotic syndrome. Proteinuria are many adult urinary protein excretion> 3.5 g / D. In normal physiological conditions, glomerular filtration membrane having molecular barrier and barrier electric charge, resulting in increased protein content in the original urine, when much more than the tubule proximal again when absorption, form many proteinuria. On this basis, any increased pressure and cause high glomerular perfusion, high filtration factors (eg, hypertension, a high protein diet or a large infusion of plasma proteins) may increase the urinary excretion of protein.
Low plasma albumin to <30g / NS from albumins L.Muchas lose urine promotes decompensated liver and albumin synthesis tubular increased decomposition. When liver albumin synthesis and decomposition fails lost, appears Hypoalbuminaemia. In addition, patients with NS because edema of the gastrointestinal mucosa, causing loss diet, protein intake, malabsorption or missing, is also the cause of aggravated Hypoalbuminaemia.
When does NS, hypoalbuminemia, plasma colloid osmotic pressure low ago percentage of water from endovascular enters interstitial organize, is the underlying cause of nephrotic syndrome causing edema. A study in recent years means, roughly 50% patients, normal or increased volume of blood, plasma renin level is normal or lower, some primary renal sodium and edema factor water retention ns play a role in the pathogenesis.
The cause of NS combined with hyperlipidemia far not exposed perfectly. High cholesterol and hypertriglyceridemia, LDL density of blood serum, VLDL and lipoprotein (α) increases, frequent and Hypoproteinemia coexists. Park mainly hypercholesterolemia increased hepatic lipoprotein synthesis but decomposition in the peripheral circulation also plays a role in the reduction. Park primarily hypertriglyceridemia disorder caused by catabolism, increased hepatic synthesis of factors is that side.