Nephrotic Syndrome

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Urology

9. What is the main cause of nephrotic syndrome?

Ans:

Increased protein excretion in the urine, low blood protein levels, high levels of cholesterol and triglycerides, and swelling (edema) are all signs of the kidney condition nephrotic syndrome. Numerous factors can contribute to the illness, but the fundamental underlying mechanisms involve damage to the kidneys' glomeruli, which function as filters.

Nephrotic syndrome's basic causes can be divided into primary and secondary categories. While secondary nephrotic syndrome develops as a result of an underlying disease or condition, primary nephrotic syndrome describes situations in which kidney disease is the primary problem. Following are a few of the typical causes:

Principal Causes:

1.     Minimal change disorder (MCD): This condition affects youngsters most frequently, and its exact cause is unknown.

2.     FSGS, or focal segmental glomerulosclerosis: It happens when specific glomeruli become scarred. The root reason may be acquired or hereditary, as well as connected to other illnesses or medications.

3.     Membranous nephropathy: This condition is characterized by thickening of the glomerular basement membrane and has autoimmune, infectious, drug-related, or systemic illness origins as possible causes.

Supplementary causes:

1.     Diabetes: Nephrotic syndrome and renal damage are frequently brought on by diabetic nephropathy.

2.     Systemic lupus erythematosus (SLE): Lupus nephritis, a kidney inflammation related to systemic lupus erythematosus (SLE), can result in nephrotic syndrome.

3.     Amyloidosis: Nephrotic syndrome can be brought on by abnormal protein buildup in the kidneys.

4.     Infections: Nephrotic syndrome can be brought on by a number of illnesses, including hepatitis B and C, HIV, and malaria.

5.     Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs), for example, have a small but conceivable risk of developing nephrotic syndrome.

It's crucial to remember that this is not a comprehensive list and that nephrotic syndrome can have additional, less common causes and variations. The precise cause can differ from person to person, so a complete medical evaluation is required to ascertain the underlying cause and create an effective treatment strategy.

10. What is the definition of advanced stage three chronic kidney disease?

Ans:

§  According to the Kidney Disease Improving Global Outcomes (KDIGO) classification system, advanced stage three chronic kidney disease (CKD) designates a particular stage of renal disease. A hallmark of chronic kidney disease (CKD) is the increasing decline of kidney function over time.

§  Based on the estimated glomerular filtration rate (eGFR), a measurement of how well the kidneys are removing waste from the blood, the KDIGO classification system separates CKD into five phases. Stage 3A and stage 3B are the two sub-stages that make up stage 3 of CKD.

§  The eGFR ranges from 45 to 59 millilitres per minute per 1.73 square metres of body surface area (mL/min/1.73 m2) in stage 3A CKD. This suggests that kidney function has decreased in a mild to moderate manner.

§  The eGFR in stage 3B CKD ranges from 30 to 44 mL/min/1.73 m2. A moderate to severe decline in renal function is indicated by this.

§  It's crucial to understand that other factors are considered in addition to eGFR when assessing the stage of CKD. Other factors are also considered, such as kidney disease or albuminuria (the presence of albumin, a protein, in the urine).

§  It is advised that you speak with a healthcare provider if you are worried about your kidney health or have been told that you have advanced stage 3 CKD. This person may offer you individualised information and advice based on your particular circumstances.

11. What are the causes of low blood pressure in people with chronic kidney disease (CKD)?

Ans:

Through a variety of causes, chronic kidney disease (CKD), often known as hypotension, can cause low blood pressure. Here are some probable reasons why patients with CKD may have low blood pressure:

1.     Volume Depletion: CKD can make it difficult for the kidneys to retain water and electrolytes, which causes an excessive amount of fluid to be lost through frequent urination. Low blood pressure may be the outcome of this volume loss.

2.     Medication: A number of drugs frequently used for CKD, like diuretics, have the potential adverse effect of lowering blood pressure. These drugs are frequently used to address oedema and hypertension as well as to regulate fluid balance. To avoid dangerously low blood pressure, their use may need to be carefully modulated.

3.     Anaemia: When red blood cells or haemoglobin levels fall, anaemia—a frequent CKD complication—occurs. Anaemia can reduce the blood's ability to carry oxygen, which can cause the blood pressure to drop.

4.     Autonomic Dysfunction: CKD can impair the autonomic nerve system's proper operation, which is essential for controlling blood pressure. Low blood pressure can be caused by inadequate vasoconstriction (narrowing of the blood vessels), which can be caused by autonomic dysfunction.

5.     Dialysis: Rapid fluid evacuation during dialysis sessions can lower blood pressure in people with end-stage renal disease (ESRD) who need the treatment. Dialysis-induced hypotension is the common name for this condition.

6.     Cardiovascular Disease: Heart failure and coronary artery disease are two disorders that are more likely to develop in people with CKD. Due to decreased cardiac output and impeded blood flow, these disorders may be a factor in low blood pressure.

It is significant to remember that low blood pressure in CKD can have a variety of multifactorial causes and can differ from person to person. Working closely with their medical professionals is crucial for people with CKD to appropriately manage their blood pressure and prevent problems.

12. How do I control my uric acid level? My uric acids level is 6.7 and my ankles are hurting continuously.

Ans:

The best course of action if you're in constant discomfort and worried about your uric acid levels is to speak with a healthcare provider who can offer you individualised guidance based on your unique circumstances. Here are some general pointers that might be useful:

1.     Dietary Changes:

§  Reduce your intake of foods high in purines, including organ meats, shellfish, red meat, and some varieties of fish (such as anchovies and sardines).

§  Reduce your intake of high-fructose corn syrup because it may cause your body to produce more uric acid. This is present in various fruits, processed meals, and sweetened beverages.

§  Eat more complex carbs, like those found in whole grains, fruits, and vegetables.

§  Make sure you're getting enough water each day to stay hydrated.

2.     Weight Control:

§  Maintain a healthy weight or reduce your weight if you're obese because being overweight can raise your uric acid levels.

3.     Medications:

§  If necessary, your doctor may recommend xanthine oxidase inhibitors (like allopurinol) or uricosuric medicines (like probenecid) to assist lower uric acid levels. A healthcare provider should explain and prescribe these drugs.

4.     Changes in Lifestyle:

§  Consume alcohol in moderation as it may impair the body's ability to rid itself of uric acid.

§  By consuming adequate liquids throughout the day, you can prevent dehydration.

§  A healthy weight can be maintained and overall health can be enhanced with regular exercise.

Always seek the opinion of a healthcare professional for a precise diagnosis and tailored recommendations. They can evaluate your particular circumstance, place any necessary orders for tests, and offer suitable treatments to control your uric acid levels and lessen your ankle pain.