Kühne Lucas, Brinkkötter Paul Thomas
Dtsch Med Wochenschr. 2019 Mar;144(6):376-381. doi: 10.1055/a-0664-5507. Epub 2019 Mar 14.
Edema is a common symptom with mostly extrarenal causes. Nevertheless, it may also be a sign of glomerular disease. So renal causes should always be clarified to avoid serious complications, such as renal insufficiency, cardiovascular or thrombembolic events. The determination of the albumin-creatinine ratio in spot urine is easy to perform and the method of choice to diagnose nephrotic-range proteinuria. Renal biopsy then usually allows the definitive assignement to either glomerular or systemic disease. Salt restriction in combination with diuretics and antiproteinuric treatment are essential for an effective therapy. Depending on the underlying disease and individual risk factors, anticoagulation should also be considered.
水肿是一种常见症状，主要由肾外原因引起。然而，它也可能是肾小球疾病的一个迹象。因此，应始终明确肾脏病因，以避免严重并发症，如肾功能不全、心血管或血栓栓塞事件。测定随机尿中的白蛋白-肌酐比值操作简便，是诊断肾病范围蛋白尿的首选方法。肾活检通常可以明确诊断是肾小球疾病还是全身性疾病。限盐联合利尿剂和抗蛋白尿治疗是有效治疗的关键。根据潜在疾病和个体风险因素，也应考虑抗凝治疗。
