Differential diagnosis of kidney disease

NS complications are important factors affecting the long-term prognosis of patients should be actively prevention and treatment.

1. infection

Usually in the hormone treatment without the use of antibiotics to prevent infection, or not only fail to prevent the purpose, but may induce fungal infection. Once found infection, should be timely selection of pathogenic bacteria sensitive, potent and no renal toxicity of active treatment of antibiotics, a clear infection should be removed as soon as possible. Severe infection is difficult to control should be considered to reduce or disable the hormone, but depends on the specific circumstances of the patient.

2. Thrombosis and embolism complications

It is generally believed that when plasma albumin is less than 20 g / L (idiopathic membranous nephropathy less than 25 g / L) anticoagulant therapy can be given heparin (also available low molecular weight heparin) subcutaneous injection or oral warfarin. Anticoagulation at the same time can be supplemented by antiplatelet drugs, such as dipyridamole or aspirin orally. On the occurrence of thrombosis, embolism should be as early as possible (6 hours the best results, but still effective within 3 days) to give urokinase or streptokinase systemic or local thrombolysis, combined with anticoagulant therapy, anticoagulants should generally continue to use More than six months. Anticoagulation and thrombolytic therapy should avoid excessive drug lead to bleeding.

3. acute renal failure

NS complicated with acute renal failure such as improper handling can be life-threatening, if given timely treatment, the majority of patients is expected to recover. The following measures can be taken:

(1) loop diuretics on loop diuretics are still effective should be a larger dose to wash the blocked tubular tubules;
(2) hemodialysis diuretic ineffective, and has reached the dialysis indications, should be hemodialysis to maintain life, and after the appropriate addition of plasma products dehydration to reduce renal interstitial edema;
(3) the original disease treatment because of its pathological type mostly small lesions of kidney disease, should be actively treated;
(4) alkaline urine can be oral sodium bicarbonate alkaline urine, in order to reduce tube formation.

4. Protein and fat metabolism disorders

It is often difficult to correct metabolic disorders before NS remission, but should adjust the amount and structure of protein and fat in the diet, and strive to minimize the impact of metabolic disorders. At present, many drugs can be used to treat protein and fat metabolism disorders. Such as: ACEI and angiotensin Ⅱ receptor antagonists can reduce urinary protein; studies have suggested that traditional Chinese medicine Astragalus can promote liver albumin synthesis, and may also reduce the role of hyperlipidemia. (HMG-CoA) reductase inhibitors, such as lovastatin statins, or lower triglyceride-based clofibrate Class, such as fenofibrate and so on. NS remission after hyperlipidemia can be natural relief, you do not need to continue drug treatment.

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