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[Edema - the nephrologist's perspective].

Lucas Kühne, Paul Thomas Brinkkötter

    Deutsche Medizinische Wochenschrift (1946)
    |March 15, 2019
    PubMed
    Summary
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    Edema can signal kidney disease, necessitating evaluation to prevent complications like renal insufficiency. Diagnosing nephrotic-range proteinuria with the albumin-creatinine ratio and renal biopsy is key for effective treatment.

    Area of Science:

    • Nephrology
    • Internal Medicine
    • Clinical Diagnostics

    Background:

    • Edema is a frequent clinical sign, often stemming from non-renal (extrarenal) origins.
    • However, edema can also indicate underlying glomerular disease, a serious renal condition.
    • Failure to identify renal causes of edema may lead to severe complications, including renal insufficiency and cardiovascular events.

    Purpose of the Study:

    • To emphasize the importance of investigating renal causes of edema.
    • To highlight diagnostic methods for nephrotic-range proteinuria.
    • To outline therapeutic strategies for edema secondary to kidney disease.

    Main Methods:

    • Assessment of edema etiology, focusing on differentiating renal from extrarenal causes.
    • Utilizing the albumin-creatinine ratio in spot urine for diagnosing nephrotic-range proteinuria.

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  • Employing renal biopsy for definitive etiological assignment of glomerular or systemic diseases.

    • Main Results:

    • The albumin-creatinine ratio is the preferred method for diagnosing nephrotic-range proteinuria.
    • Renal biopsy provides definitive diagnosis for glomerular and systemic diseases.
    • Effective management involves salt restriction, diuretics, and antiproteinuric therapy.

    Conclusions:

    • Edema warrants thorough investigation for potential renal involvement to prevent serious health consequences.
    • Prompt diagnosis of nephrotic-range proteinuria and underlying glomerular disease is crucial.
    • Comprehensive treatment includes lifestyle modifications, medication, and consideration of anticoagulation based on individual risk.