The 'kidney injury' of patients with nephrotic syndrome
Most patients with nephrotic syndrome need to use: the most classic, most economical, most effective, and most effective glucocorticoids (hereafter referred to as hormones) with the best measures to deal with "negative effects"; if it is a primary lesion and there are no contraindications, the first choice Drugs are naturally hormones; but many patients are always concerned about the side effects of hormones, and delay receiving this treatment; they do not know that it is precisely during these delays that the condition will be greatly affected; there is such a phenomenon in clinical practice, that is, those who It is finally confirmed that for patients who can be relieved by hormone therapy, the time of remission is closely related to the morning and evening of entering hormone therapy: patients who enter regular hormone therapy more than one month after the onset of the disease often have their disease remission within one month. Those who entered regular hormone therapy only 3 months after the onset of the disease_relieved only after 100 days of treatment, while those who entered the hormone therapy program 6 months after the onset of the disease_relieved after one year of treatment, and those who entered hormone therapy after the onset of eight months, Then the disease that should be relieved (such as mild lesions) is also difficult to relieve! This situation all shows that: the nephrotic syndrome itself has the act of "injuring the kidney" and aggravating the disease; delaying treatment, especially hormone treatment, will drag the disease into a difficult and uncomfortable "quagmire"; Such an elderly male nephrotic syndrome patient had a "lucky" heart and hoped to use "bed rest" to relieve his condition, but it was only delayed for seven days. Not to mention, the infusion of albumin will cost more; why just a small delay in the application of hormones will cause such a big "repercussion" of the disease; how exactly does nephrotic syndrome "injury the kidney" what about? But let us analyze it one by one:
The "kidney injury point" in patients with nephrotic syndrome...
The large amount of proteinuria produced by nephrotic syndrome will directly damage the renal tubules; this is because these large amounts of proteinuria leak from the glomeruli and enter the renal tubules, and the renal tubules will receive the signal from the body: "Rescue" , to recover these "fine" substances_proteins; thus, renal tubular cells will rush to "rescue" these proteins "ashore", and they "recycle" by "phagocytosing" these proteins into the body; the amount of these proteins is too much, Some types of proteins also cause damage to the renal tubular epithelium, "phagocytosing" too much protein, causing the normal structure of the renal tubular epithelial cells to be "squeezed" and injured, resulting in aggravated renal tubular damage, which is called nephrotic syndrome. Caused by the first "kidney injury";
Severe edema in nephrotic syndrome is one of its characteristics; edema not only occurs in the limbs, but also occurs in the abdomen and gastrointestinal mucosa, which will cause digestion and absorption dysfunction, natural metabolic disorder, increase in acid metabolites in the body, The increase in acidity and the natural increase in the "acidity injury" of the blood meridian and kidney are considered to be caused by nephrotic syndrome. The second "kidney injury" can be said to solve the problems of ascites, gastrointestinal mucosa edema, and oliguria. It is the basic guarantee for the continuation of the treatment of this disease; otherwise, if the patient cannot even guarantee the basic nutritional intake, how can we treat the disease? Therefore, this is also the "benefit" of applying hormones as soon as possible, that is, after the rapid suppression of kidney disease, less protein will be lost, edema will not be so severe, gastrointestinal function will not "spread" much, and Guarantee basic nutrition for survival and ensure smooth progress of treatment;
Patients with nephrotic syndrome, the immune function declines _ This is an indisputable fact; the continuous loss of protein in the urine is like a continuous wound "bleeding", how can the body's resistance be stronger? As a result, recurrent infections are "common", and these infections cause a double "high pressure" injury to sympathetic activation (hyperglycemia, high blood pressure), injury to the release of toxins from the infectious agent, and deposition of a complex of pathogens and antibodies in the kidneys "Blood bruises" caused by injuries, pathogens and toxins will undoubtedly make kidney damage more serious, which is the third "kidney injury" caused by nephrotic syndrome.
The above are just the "kidney-injured" aspects of nephrotic syndrome that we can see and touch; there are also many tiny invisible lesions: such as platelet aggregation, prothrombin activation, fibrinogen deposition, release of inflammatory mediators, The "snowball"-like amplifying effect of kidney resident cells (epithelial, endothelial, mesangial cells) involved, hyperlipidemia directly damages the kidneys, and continuously leads to aggravation of kidney damage; it can be seen that delayed application is the most powerful. The hormone that inhibits kidney disease is undoubtedly giving up the "strongest main force", and the trend of the disease "breaking the embankment" is naturally unstoppable; therefore, patients with nephrotic syndrome who are still wandering should receive hormone therapy decisively, the sooner The more the treatment can achieve a better effect, with appropriate calcium supplementation measures, anticoagulation measures, dietary therapy, the application of traditional Chinese medicine and proprietary Chinese medicine for kidney and hormone prevention, most patients will strive for better results, and can avoid it. Hormone side effects, and the chance of recurrence after remission of the disease will also be reduced.