Nephrotic syndrome - nonspecific clinico the laboratory symptom-complex including a massive proteinuria (3,5 gram day and more), a hypoalbuminemia (fiber less than 30 g/l), a hypoproteinemia and the edemas reaching a degree of an anasarca with an edema of serous cavities. Often (but not always) the hypercholesterinemia is marked. The term « a nephrotic syndrome » is widely used in classifications of diseases of the world organization of public health services and has almost superseded the old term "nephrosis". The nephrotic syndrome happens primary and secondary. The primary nephrotic syndrome develops at actually diseases of kidneys (all morphological types of a glomerulonephritis, an amyloidosis of kidneys). The secondary nephrotic syndrome meets less often though the group of diseases causing it is rather numerous: General diseases (a systemic lupus erythematosus, a hemorrhagic vasculitis, an infectious endocarditis, a nodous polyarteritis, a systemic scleroderma), clottages of veins and arteries of kidneys, aortas or the bottom vena cava, a diabetic glomerulosclerosis, a nephropathy of pregnant women, a cancer of a kidney, a lung, a lymphogranulomatosis, allergic diseases, etc.
The pathogenesis of a nephrotic syndrome is closely bound to a basic disease. The majority listed above illnesses have an immunologic basis, that is arise owing to a deposition in organs (and a kidney) fractions of a complement, immune complexes or antibodies against an antigen of a basal membrane of a glomulus with accompanying disturbances of cellular immunity. The main part in a pathogenesis of a leading sign of a nephrotic syndrome - a massive proteinuria - is decrease or disappearance of a constant electric charge of a wall of a capillary loop of a glomulus. All other numerous disturbances at a nephrotic syndrome are secondary in relation to a massive proteinuria. So, as a result of a hypoproteinemia, delays of sodium and systemic disturbance of vascular permeability develop edemas.
Signs, current. The clinical picture of a nephrotic syndrome, besides edemas, dystrophic changes of a skin and mucosas, can become complicated peripheric phlebothromboses, a bacteriemic, virus, fungic infection of various localization, a wet brain, retinas of an eyeground, a nephrotic crisis (a hypovolemic shock). In some cases attributes of a nephrotic syndrome are combined with an arterial hypertensia (the admixed form of a nephrotic syndrome).
Diagnostics of a nephrotic syndrome of difficulties does not represent.
The diagnosis of a basic disease and nephropathy causing a nephrotic syndrome put on the basis of the anamnestic data, given clinical research and the data received by means of a puncture biopsy of a kidney (less often than other organs), and also additional laboratory methods (a cell at a systemic lupus erythematosus). Current of a nephrotic syndrome depends on the form of a nephropathy and character of a basic disease. As a whole a nephrotic syndrome - potentially curable condition. So, (even at adults) spontaneous and medicinal remissions though can be and relapses of a nephrotic syndrome (till 5-10 time within 10-20 years) are inherent to the nephrotic form of a chronic glomerulonephritis. At radical elimination of an antigen (well-timed operation at a tumour, exception of a medicine of an antigen) is possible full and stable remission of a nephrotic syndrome.
