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肾病综合征综述

Nephrotic Syndrome: A Review.

作者信息

Verma Priyanshu R, Patil Praful

机构信息

Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Microbiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Feb 9;16(2):e53923. doi: 10.7759/cureus.53923. eCollection 2024 Feb.

Abstract

Nephrotic syndrome (NS) is characterized by hypoalbuminemia, severe proteinuria, and peripheral edema, frequently in conjunction with hyperlipidemia. Individuals usually show symptoms of weariness and swelling, but no signs of serious liver damage or cardiac failure. With characteristic medical symptoms and evidence of hypoalbuminemia and severe proteinuria, NS can be diagnosed. The majority of NS episodes are classified as unexplained or primary; the most prevalent histopathological subgroups of primary NS in people are focal segmental glomerulosclerosis and membraneous nephropathy. Thrombosis of the veins with high cholesterol levels is a significant NS risk. Acute renal damage and infection are further possible side effects. The pathobiochemistry of NS involves alterations in genes that affect the selectivity of the kidneys and abnormalities in proteins related to podocytes. Understanding the molecular mechanisms that influence these processes is crucial to developing specific and targeted therapeutic approaches. The need for invasive renal biopsies throughout the diagnosis process may be lessened by the development of non-invasive nephrotic syndrome biomarkers, such as microRNAs. Corticosteroids are frequently used as the initial line of defense in NS treatment. However, some individuals need other treatments since a resistant type of NS also exists. The use of calcineurin inhibitors, mycophenolate mofetil, and rituximab is mentioned in the text, along with current research to identify safer and more efficient therapeutic choices. The complicated kidney condition NS has several underlying causes and symptoms. For the diagnosis of this ailment as well as the creation of focused therapies, an understanding of the pathophysiology and the identification of possible biomarkers are essential.

摘要

肾病综合征(NS)的特征是低白蛋白血症、严重蛋白尿和外周水肿,常伴有高脂血症。患者通常表现出疲倦和肿胀症状,但无严重肝损伤或心力衰竭迹象。根据典型的医学症状以及低白蛋白血症和严重蛋白尿的证据,可诊断出NS。大多数NS发作被归类为不明原因或原发性;原发性NS在人群中最常见的组织病理学亚组是局灶节段性肾小球硬化和膜性肾病。高胆固醇水平导致的静脉血栓形成是NS的一个重大风险。急性肾损伤和感染也是可能的副作用。NS的病理生物化学涉及影响肾脏选择性的基因改变以及与足细胞相关的蛋白质异常。了解影响这些过程的分子机制对于开发特定的靶向治疗方法至关重要。非侵入性肾病综合征生物标志物(如微小RNA)的开发可能会减少整个诊断过程中对侵入性肾活检的需求。皮质类固醇经常被用作NS治疗的一线药物。然而,由于存在耐药型NS,一些患者需要其他治疗方法。文中提到了钙调神经磷酸酶抑制剂、霉酚酸酯和利妥昔单抗的使用,以及目前旨在确定更安全、更有效治疗选择的研究。复杂的肾脏疾病NS有多种潜在病因和症状。对于这种疾病的诊断以及制定针对性治疗方案,了解病理生理学和识别潜在生物标志物至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d601/10924861/56e4108e175a/cureus-0016-00000053923-i01.jpg

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