Nephrotic Syndrome
A nephrotic syndrome is a kidney disorder that causes the body to excrete too much protein in the urine.
Nephrotic syndrome is usually caused by the damage to the clusters of small blood vessels. When healthy, these vessels keep blood protein from seeping into the urine and out of the body.
Causes:
1.Chronic glomerulonephritis Diabetes mellitus
2.Systemic lupus erythematosus. This chronic inflammatory disease can lead to serious kidney damage.
3.Certain medications. Medications that might cause nephrotic syndrome include nonsteroidal anti inflammatory drugs and drugs used to fight infections.
4.Blood clot in kidney veins Certain infections
Pathophysiology of nephrotic Syndrome
Clinical manifestation :
1.Swelling particularly around your eyes and in your ankles and feet.
2.Weight gain due to fluid retention
3.Fatigue
4.Oligouria
5.Hematuria
6.Hypertension
7. Proteinuria
8. Foamy urine, a result of excess protein in your urine
Diagnostic evaluations :
1.History collection
2.Physical examination
3.Chest x-ray
4.MRI and CT scan
5.Ultrasonography (KUB)
6.Urine tests. A urinalysis can reveal abnormalities in your urine, such as large amounts of protein. You might be asked to collect urine samples over 24 hours.
7.Kidney biopsy:- Your doctor might recommend removing a small sample of kidney tissue for testing. During a kidney biopsy, a needle is inserted through your skin and into your kidney. Kidney tissue is collected and sent to a lab for testing..
8.Blood tests:- A blood test can show low levels of the protein albumin and often decreased levels of blood protein overall. Loss of albumin is often associated with an increase in blood cholesterol and blood triglycerides. The creatinine and urea nitrogen levels in your blood also might be measured to assess your overall kidney function.
Management :
1.Blood pressure medications:- Drugs called angiotensin-converting enzyme (ACE) inhibitors reduce blood pressure.
2.Diuretics:-These help control swelling by increasing your kidneys' fluid output. Diuretic medications typically include furosemide (Lasix). Others include spironolactone (Aldactone, Carospir) and thiazides, such as hydrochlorothiazide.
3.Cholesterol-reducing medications :-Statins can help lower cholesterol levels. Statins include atorvastatin.
4.Immune system-suppressing medications:-Medications to control the immune system, such as corticosteroids, can decrease the inflammation.
Dietary management :
1.Fluid restrictions
2.Protein diet according to the Proteinuria
3.Sodium restrictions
Nursing management :
1.Daily assessment of the patient
2.Checking vitals sign
3.Instruct the patient to follow all medications and dietary management
4.checking Urine output and fluid intake
5.Instructing Fluid restricted diet
6.Checking skin intigrity
7.Checking pitting edema
8.Maintaing aseptic techniques
9.Routine monitoring of serum protein level
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