Mahalingasivam Viyaasan, Booth John, Sheaff Michael, Yaqoob Magdi
BMedSci MRCP, Renal Unit, Royal London Hospital, Barts Health NHS Trust, London, UK.
PhD MRCP, Renal Unit, Royal London Hospital, Barts Health NHS Trust, London, UK.
Acute Med. 2018;17(1):36-43.
Nephrotic syndrome is an important presentation of glomerular disease characterised by heavy proteinuria, hypoalbuminaemia and oedema. The differential diagnosis of the underlying condition is wide including primary renal disorders and secondary diseases such as malignancy, infection, diabetes and amyloid. Presentations to acute medicine may be with hypervolaemia, complications of the nephrotic state (such as venous thromboembolism), or complications of therapy (such as infection). Early recognition of nephrotic syndrome is possible through simple urinalysis for protein and testing serum albumin, although a high index of suspicion is sometimes required in patients with comorbidities including potentially distracting cardiac or hepatic diseases.
肾病综合征是肾小球疾病的一种重要表现，其特征为大量蛋白尿、低白蛋白血症和水肿。潜在病因的鉴别诊断范围广泛，包括原发性肾脏疾病以及继发性疾病，如恶性肿瘤、感染、糖尿病和淀粉样变性。急性内科就诊时可能表现为血容量过多、肾病状态的并发症（如静脉血栓栓塞）或治疗并发症（如感染）。通过简单的尿蛋白分析和血清白蛋白检测可以早期识别肾病综合征，尽管对于合并有潜在干扰性心脏或肝脏疾病等合并症的患者，有时需要高度怀疑。
