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[肾病综合征]

[Nephrotic syndrome].

作者信息

Braun Daniela Anne, Pavenstädt Hermann-Josef

机构信息

Medizinische Klinik D, Universitätsklinikum Münster, Münster, Deutschland.

出版信息

Inn Med (Heidelb). 2025 Sep;66(9):917-926. doi: 10.1007/s00108-025-01946-w. Epub 2025 Aug 4.

Abstract

Nephrotic syndrome (NS) is characterized by proteinuria > 3.5 g/day, hypoalbuminemia, peripheral edema, and hyperlipidemia. Common primary causes of NS are podocytopathies, such as minimal change nephropathy, focal segmental glomerulosclerosis, and membranous nephropathy. In a subset of patients with primary NS autoantibodies against podocyte antigens can be detected. Diabetes mellitus, amyloidosis, systemic lupus erythematosus, malignancies, infections, and medications are some of the numerous secondary causes of NS. Beside searching for secondary causes, a kidney biopsy is usually performed to define the entity of NS. Complications of NS include venous thrombosis, infections, and the development of acute or chronic kidney disease. Sodium restriction, loop diuretics, statins, possibly anticoagulation, and antiproteinuric therapy are important measure for supportive therapy in NS. In addition, immunosuppressive treatment is often required.

摘要

肾病综合征(NS)的特征为蛋白尿>3.5克/天、低白蛋白血症、外周水肿和高脂血症。NS常见的原发性病因是足细胞病,如微小病变性肾病、局灶节段性肾小球硬化症和膜性肾病。在一部分原发性NS患者中可检测到针对足细胞抗原的自身抗体。糖尿病、淀粉样变性、系统性红斑狼疮、恶性肿瘤、感染及药物等是NS众多继发性病因中的一部分。除了寻找继发性病因外,通常还会进行肾活检以明确NS的类型。NS的并发症包括静脉血栓形成、感染以及急慢性肾脏病的发生。限钠、襻利尿剂、他汀类药物、可能还需抗凝以及抗蛋白尿治疗是NS支持治疗的重要措施。此外,通常还需要进行免疫抑制治疗。

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