Kidney Diseases: Understanding Nephrotic Syndrome and Chronic Kidney Disease

Kidney Diseases: Understanding Nephrotic Syndrome and Chronic Kidney Disease

This article will focus on two common kidney diseases: Nephrotic Syndrome (NS) and Chronic Kidney Disease (CKD). We will delve into the causes, pathogenesis, symptoms, diagnosis, treatment, and complications of these two conditions.

1. Nephrotic Syndrome (NS):

1.1. Causes:

NS is often caused by primary glomerulonephritis, an abnormal immune response that leads to inflammation and damage of the glomeruli. NS can also be a complication of other conditions such as:

• Autoimmune diseases: Systemic lupus erythematosus, rheumatoid arthritis, …

• Infections: Hepatitis B virus infection, sepsis, …

• Other diseases: Type 2 diabetes, polycystic kidney disease, renal amyloidosis,…

1.2. Pathogenesis:

NS is caused by the deposition of antigen-antibody complexes in the glomeruli. This immune response triggers inflammation and damage of the glomeruli, leading to leakage of protein into the urine.

1.3. Symptoms:

NS has characteristic symptoms:

• Proteinuria: Increased protein in urine, often above 3.5g/24h.

• Edema: Swelling in the feet, face, ankles,… due to decreased plasma colloid osmotic pressure.

• Hypertension: Due to glomerular damage causing reduced blood flow to the kidneys, which stimulates the renin-angiotensin system, leading to hypertension.

• Kidney failure: In severe cases, NS can lead to kidney failure, characterized by a decrease in kidney filtering function.

1.4. Diagnosis:

• Urinalysis: Detects proteinuria, hematuria, leukocyturia.

• Blood tests: Determine blood protein levels, albumin levels, creatinine levels, blood urea nitrogen levels.

• Kidney ultrasound: Assess kidney size and the appearance of kidney parenchyma.

• Kidney biopsy: Allows identification of the cause and extent of glomerular damage.

1.5. Treatment:

• Treating the cause: Managing underlying conditions like diabetes, infections, …

• Treating symptoms: Controlling blood pressure, reducing edema, adjusting diet, using immunosuppressive drugs,…

• Supportive treatment: Protein supplementation, fluid replacement, vitamin supplementation,…

1.6. Complications:

• Chronic kidney disease: The most serious complication of NS, requiring dialysis or kidney transplantation to sustain life.

• Dyslipidemia: Due to decreased blood protein levels, the liver increases the synthesis of lipoproteins.

• Coagulation disorders: Due to decreased clotting factors, increasing the risk of bleeding.

• Infection: Due to decreased body immunity.

2. Chronic Kidney Disease (CKD):

2.1. Causes:

CKD can be caused by various factors, including:

• Glomerular diseases: Chronic glomerulonephritis, recurrent NS,…

• Tubulointerstitial diseases: Chronic pyelonephritis, polycystic kidney disease,…

• Kidney vascular diseases: Hypertension, diabetes,…

• Other causes: Drug-induced kidney disease, kidney stones, toxic exposure,…

2.2. Pathogenesis:

CKD is a gradual process of kidney damage that leads to a decrease in kidney filtering function. The cause of CKD is often chronic damage to the glomeruli, tubules, kidney blood vessels,…

2.3. Symptoms:

• Decreased filtration function: Reflected by increased blood creatinine, blood urea nitrogen,…

• Anemia: Due to decreased erythropoietin production.

• Hypertension: Due to increased activity of the renin-angiotensin system.

• Electrolyte disturbances: Decreased blood calcium, increased blood potassium, increased blood phosphorus,…

• Bone disorders: Renal osteodystrophy due to kidney failure.

• Other symptoms: Loss of appetite, nausea, diarrhea, edema,…

2.4. Diagnosis:

• Urinalysis: Detects proteinuria, hematuria, leukocyturia,…

• Blood tests: Determine blood creatinine, blood urea nitrogen, blood calcium, blood phosphorus, blood erythropoietin,…

• Kidney ultrasound: Assess kidney size and the appearance of kidney parenchyma.

• Kidney biopsy: Identify the cause and extent of kidney damage.

2.5. Treatment:

• Treating the cause: Managing underlying conditions like diabetes, hypertension,…

• Treating symptoms: Controlling blood pressure, reducing edema, adjusting diet, supplementing erythropoietin,…

• Supportive treatment: Protein supplementation, fluid replacement, vitamin supplementation,…

2.6. Complications:

• End-stage kidney disease: Requires dialysis or kidney transplantation to sustain life.

• Hypertension: Uncontrolled hypertension.

• Anemia: Severe chronic anemia.

• Bone disorders: Renal osteodystrophy, spontaneous fractures.

• Cardiovascular disorders: Heart failure, myocardial infarction,…

• Neurological disorders: Sensory disturbances, numbness,…

Conclusion:

NS and CKD are serious kidney diseases that can cause many severe complications, affecting the health and lives of patients. Therefore, early detection, accurate diagnosis, and timely treatment are crucial to preventing complications, prolonging life expectancy, and improving the quality of life for patients.

Note: This article provides general information about kidney diseases and is not a substitute for professional medical advice.