Q:Here is the medical reports about my sister who is a patient with nephrotic syndrome. Please analyze it and give us the best advice. Urine protein: 2+; total protein: 4.4; albumin: 2.3; ESR: 55; HB: 12.6; Cholesterol: 379; HDL: 103; LDL: 258.
Her kidney function is still good, but the condition is very dangerous now.
Her protein leakage is too much, especially it lasts for long time already. According to the report, her total protein and the serum albumin are both low. If the serum albumin is low, the plasma colloid osmotic pressure will be low and the water in blood will run into the tissue space and cause swelling on eyelids and lower limbs first.
When the serum protein and albumin are low, the liver will work harder to synthetize protein. However, a large amount of lipoprotein will be produced at the same time. That's why her blood lipid is so high. If this condition cannot be solved in time, it is easy to cause blood clots. Many patients die of blood clots in lungs. If the protein leakage in urine cannot be stopped in time, the swelling will be more serious.
Please don't worry. I think her doctor is wise enough to control her condition in time. Even there is not a clear diagnosis before the biopsy report comes out, she should start steroids to control the protein in urine and take medications like Rosuvastatin to lower the blood lipid. Besides, even if her blood pressure is not high, she can take ACEI or ARB to make the blood pressure stable. The AECI and ARB also have some effect of reducing protein in urine.
You can observe her condition. If her serum albumin continues to decline, she may need albumin infusion to maintain the condition.
Nephrotic Syndrome is just a general name of a group of symptoms like large amount of protein leakage, high blood pressure, swelling, high blood lipid and low albumin. There are five kinds of pathological changes of Nephrotic Syndrome. The root cause of the protein leakage is damage to glomerular epithelial cells. We have to stop the inflammation in the kidneys, remove the immune complex and repair the damaged kidney cells so as to cure this disease fundamentally.
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