Insights into Nephrotic Syndrome in Pediarics: Case Series Analysis

V. Sireesha, Asiya Sultana, P. R. Sri, Ayesha Mateen, M. Shiva, T. R. Rao
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Abstract

Nephrotic syndrome (NS) is one of the most common childhood kidney diseases. NS can affect children of any age from infancy to adolescence and predominantly occurs in the age group of 1–6 years. It is an illness caused by idiopathic diseases like minimal change nephrotic syndrome (MCNS) and focal segmental glomerulosclerosis (FSGS), membrane proliferative Glomerulonephritis, membranous Glomerulonephritis and is characterized by increased permeability across the glomerular filtration barrier. NS is classified as primary, secondary, and congenital. It consists of four clinical features like severe proteinuria, edema, hyperlipidaemia, hypoalbuminemia. The main cause of nephrotic syndrome are diseases associated with drugs and rarely genetic disorders. The pathogenesis of the disease affects various biological functions linked to loss of proteins negatively, which results in systemic complications which may be disease and drug-associated complications. Using drugs to treat NS leads to several complications which include improper growth, metabolism, behavior change inpatient. Itis a chronic relapsing disease for most of the steroid response drugs for treatment of nephrotic syndrome. Glucocorticoids, immunosuppressants and biological agents are used for the treatment of the diseases. In this case series, we presented a case series of nephrotic syndrome in pediatrics. Total 4 patients were taken into considerations. The patients came with a chief complaints of swelling of face, foamy urine, abdominal pain, dark coloured urine with decreased urine output, joint pains. The laboratory investigations for all the 4 patients showed that there were decrease in albumin levels (hypoalbuminemia), decrease in serum creatinine levels and protein in urine, although kidney biopsy couldn’t be perform but the diagnosis was made based on clinical and laboratory findings. The patients were mainly treated with prednisolone, pantoprazole, enalapril, nifedipine, amoxiclav, and even albumin transfusion were done. NS was successfully managed and fortunately the patients recovered.
对小儿肾病综合征的认识:病例系列分析
肾病综合征(NS)是最常见的儿童肾脏疾病之一。肾病综合征可影响从婴儿到青少年的任何年龄段的儿童,主要发生在 1-6 岁年龄组。它是由微小病变肾病综合征(MCNS)、局灶节段性肾小球硬化症(FSGS)、膜增生性肾小球肾炎、膜性肾小球肾炎等特发性疾病引起的疾病,其特点是肾小球滤过屏障的通透性增加。NS 可分为原发性、继发性和先天性。它包括四个临床特征,如严重蛋白尿、水肿、高脂血症和低蛋白血症。肾病综合征的主要病因是与药物有关的疾病,很少有遗传性疾病。该病的发病机制影响各种生物功能,与蛋白质的负面损失有关,从而导致全身并发症,可能是疾病并发症,也可能是药物相关并发症。使用药物治疗 NS 会导致多种并发症,包括生长发育不良、新陈代谢紊乱、住院病人行为改变等。对于大多数治疗肾病综合征的类固醇反应药物来说,这是一种慢性复发性疾病。糖皮质激素、免疫抑制剂和生物制剂被用于治疗该病。在本病例系列中,我们介绍了儿科肾病综合征的病例系列。该病例共涉及 4 名患者。患者的主诉为面部浮肿、泡沫尿、腹痛、深色尿液且尿量减少、关节疼痛。所有 4 名患者的实验室检查均显示白蛋白水平下降(低白蛋白血症)、血清肌酐水平下降和尿蛋白,虽然无法进行肾活检,但根据临床和实验室检查结果做出了诊断。患者主要接受了泼尼松龙、泮托拉唑、依那普利、硝苯地平、阿莫西林等药物治疗,甚至还进行了白蛋白输注。NS得到了成功控制,幸运的是患者都已康复。
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