nephrotic syndrome

Nephrotic syndrome is a nonspecific disorder in which the kidneys are damaged, causing them to leak large amounts of protein^[1] (proteinuria at least 3.5 grams per day per 1.73m² body surface area)^[2] from the blood into the urine.

Kidneys affected by nephrotic syndrome have small pores in the podocytes, large enough to permit proteinuria (and subsequently hypoalbuminemia, because some of the protein albumin has gone from the blood to the urine) but not large enough to allow cells through (hence no hematuria). By contrast, innephritic syndrome, RBCs pass through the pores, causing hematuria.

Signs and symptoms

It is characterized by proteinuria (>3.5g/day), hypoalbuminemia, hyperlipidemia and edema which is generalized & also known as anasarca or dropsy. Common among 2–6 years old boys. The edema begins in the face. Lipiduria (lipids in urine) can also occur, but is not essential for the diagnosis of nephrotic syndrome. Hyponatremia also occurs with a low fractional sodium excretion.

Hyperlipidemia is caused by two factors:

• Hypoproteinemia stimulates protein synthesis in the liver, resulting in the overproduction of lipoproteins.
• Lipid catabolism is decreased due to lower levels of lipoprotein lipase, the main enzyme involved in lipoprotein breakdown.^[3]

A few other characteristics seen in nephrotic syndrome are:

• The most common sign is excess fluid in the body due to the serum hypoalbuminemia. Lower serum oncotic pressure causes fluid to accumulate in the interstitial tissues. Sodium and water retention aggravate the edema. This may take several forms:
  • Puffiness around the eyes, characteristically in the morning.
  • Pitting edema over the legs.
  • Fluid in the pleural cavity causing pleural effusion. More commonly associated with excess fluid is pulmonary edema.
  • Fluid in the peritoneal cavity causing ascites.
  • Generalized edema throughout the body known as anasarca.
• Most of the patients are normotensive but hypertension (rarely) may also occur.
• Anemia (iron resistant microcytic hypochromic type) maybe present due to transferrin loss.
• Dyspnea maybe present due to pleural effusion or due to diaphragmatic compression with ascites.
• Erythrocyte sedimentation rate is increased due to increased fibrinogen & other plasma contents.
• Some patients may notice foamy or frothy urine, due to a lowering of the surface tension by the severe proteinuria. Actual urinary complaints such as hematuria or oliguria are uncommon, though these are seen commonly in nephritic syndrome.
• May have features of the underlying cause, such as the rash associated with systemic lupus erythematosus, or the neuropathy associated with diabetes.
• Examination should also exclude other causes of gross edema—especially the cardiovascular and hepatic system.

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info di atas aku copy dr wikipedia

physically fahry stabil 

kalau kaki dia takde line ubat dia masih lg cergas lari sana sini

so layan je la youtube rasa nak beli Ipad ke tablet
camno nie?
makcik dah

sister tegur juge sbb charge laptop 

luckily dpt duduk dpt bilik

agak selesa bilik nie walopon mlm aku tido alas toto

dah boleh buat mcm rumah sendiri je

 dah 2 hari doc pakar mention utk monitor urine + blood sample

mmg confirm +ve protein dlm urine & protein kurang dalam darah

since aku chck in kt sini dh byk kali doc explain kat aku

seb baik amek biology, paham la jugak konsep yg doc cite

protein utk ctrl kandungan air dlm darah

since protein kurang maka kandungan air tue sume lari pegi tissue

that causing the puffiness

remember sylabus OSMOSIS subjek biology form 4??

hari ini fahry akan strt mkn ubat **apo ntah

utk cure failure kidney tue

walaubagaimanapon ubat berkenaan ada side effect

sistem imun akan kurang, mean dia takleh dekat dgn org sakit

then selera makan akan bertambah

ada satu lg aku xingat tp berkenaan dgn dua effect kat atas

after few discussion with en.suami

kami akan cuba jugak perubatan alternatif

selain maintain ubat hospital

MAMA DOAKAN FAHRY CEPAT SEMBUH, PULIH MCM BIASA

TAHUN NIE TAK RAYA PON TAKPE JANJI FAHRY SIHAT

AMIN
kepada yang sempat visit fahry semalam
terima kasih byk atas doa & ingatan
semutmerah n makbed pelawat terawal sbb melawat bukan time melawat
=D