The differential diagnosis of nephrotic syndrome

Nephrotic syndrome is a group of clinical manifestations similar syndrome, it is not an independent disease. The main clinical manifestations of proteinuria, hypoproteinemia, edema, hyperlipidemia. From nephrotic syndrome for many reasons. Can be summed up can be divided into two broad categories. Namely: primary and secondary. Primary and secondary nephrotic syndrome although there are common clinical manifestations, but in the etiology, pathogenesis and treatment in very different. Therefore they must go further in the differential diagnosis. 1. Primary nephrotic syndrome Primary nephrotic syndrome. Glomerular diseases caused by the primary, such as minimal change nephropathy, membrane-type kidney disease, mesangial proliferative kidney disease, mesangial proliferative glomerulonephritis, such as focal segmental glomerulosclerosis. (1) minimal change nephropathy, more common in children and adolescents. Misprision of onset, gross hematuria. (2) membrane nephropathy, the general incidence in the 35-year-old after the onset occult lesions development has been slow and prone to renal vein thrombosis, gross hematuria rare. (3) mesangial proliferative kidney disease, multiple in the past 30 years, rapid onset, almost all the patients had microscopic hematuria, renal function was a decline of about 1 / 3 of patients with hypertension. (4) mesangial proliferative glomerulonephritis, occur in young people, misprision of onset, can be acute, and more with hematuria, mainly to microscopic hematuria, and mild to moderate hypertension. (5) Focal segmental glomerulosclerosis, a predilection for young people, the majority in almost all patients with occult disease is the most frequently nephrotic syndrome, followed by microscopic hematuria, the decline of renal function. 2. Secondary nephrotic syndrome Secondary nephrotic syndrome due to a combination of disease, such as systemic diseases, metabolic diseases, allergic diseases, infectious diseases, kidney toxicity, cancer, genetic diseases, pregnancy toxaemia and chronic renal transplantation exclusion, and so on. But a common clinical only a few, such as systemic lupus erythematosus kidney, diabetic nephropathy, renal amyloidosis, Henoch-Schonlein Purpura Nephritis, etc. The most common. (1) systemic lupus erythematosus nephropathy common in young women, often more for the performance of harm, such as joint pain, fever, butterfly facial erythema, liver and cardiovascular system diseases, etc.. SLE can be found in blood cells, plasma globulin increased significantly. (2) diabetic nephropathy multiple longer history of diabetes in patients with diabetic retinopathy, kidney damage and often parallel. (3) renal amyloidosis mainly occurs in middle-aged and older men and women, tend to have chronic inflammation or chronic suppurative disease lesions. (4) Multiple Purpura Nephritis in young people, and the incidence of respiratory tract infection, may be winter Most of hematuria is Henoch-Schonlein purpura renal kidney damage the most common clinical manifestations.