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Videos de Conceptos Relacionados

Nephrotic Syndrome I : Introduction01:24

Nephrotic Syndrome I : Introduction

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Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of...
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Nephrotic Syndrome III : Nursing Management01:24

Nephrotic Syndrome III : Nursing Management

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Nursing management for nephrotic syndrome adapts as the disease progresses, with strategies evolving to address advancing symptoms and complications.Early-Stage Management In the early stages, nursing interventions for nephrotic syndrome resemble those used in managing acute glomerulonephritis, focusing on symptom monitoring, fluid balance, and managing mild to moderate edema.Vital Signs: Regularly monitor blood pressure, pulse, respiratory rate, and temperature to promptly identify...
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Nephrotic Syndrome II : Assessment and Medical Management01:26

Nephrotic Syndrome II : Assessment and Medical Management

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IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document...
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Nephrons01:10

Nephrons

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The kidneys are intricate organs with millions of working units known as nephrons. Each nephron features two major structures: the renal corpuscle, which facilitates blood plasma filtration, and the renal tubule, which handles the glomerular filtrate. Blood supply is directly linked to the nephrons. The renal corpuscle consists of the glomerulus, a capillary network, and the Bowman's capsule, a double-walled epithelial structure that encases the glomerulus. The filtering of blood plasma...
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Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

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Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
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Spot Urine Calcium to Creatinine Ratio: Age-Specific Reference Ranges.

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Síndrome nefrótico infantil

Marina Vivarelli1, Keisha Gibson2, Aditi Sinha3

  • 1Division of Nephrology, Laboratory of Nephrology, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.

Lancet (London, England)
|September 2, 2023
PubMed
Resumen

El síndrome nefrótico idiopático en niños se trata con corticosteroides. Los casos resistentes a los esteroides pueden requerir inmunosupresores alternativos, lo que pone de relieve la necesidad de estrategias de tratamiento adaptadas.

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Área de la Ciencia:

  • Nefrología pediátrica
  • Enfermedades glomerulares
  • Inmunodepresión

Sus antecedentes:

  • El síndrome nefrótico idiopático es la enfermedad glomerular más común en la infancia.
  • Los corticosteroides son el tratamiento primario, siendo la respuesta a los esteroides un indicador pronóstico clave.
  • El síndrome nefrótico sensible a esteroides responde al tratamiento inicial, mientras que las formas resistentes a esteroides requieren un tratamiento adicional.

Objetivo del estudio:

  • Revisar la comprensión actual de la fisiopatología del síndrome nefrótico.
  • Para delinear estrategias de tratamiento para el síndrome nefrótico sensible a esteroides, resistente a esteroides y resistente a múltiples medicamentos.
  • Hacer hincapié en el monitoreo y manejo de las complicaciones y los efectos secundarios.

Principales métodos:

  • Revisión de la literatura existente sobre el síndrome nefrótico idiopático.
  • Análisis de las respuestas al tratamiento y factores de pronóstico.
  • Discusión de la fisiopatología, incluidos los orígenes inmunomediados y monogénicos.

Principales resultados:

  • La mayoría de los niños logran remisión con esteroides orales (sensibles a los esteroides).
  • El síndrome nefrótico resistente a los esteroides a menudo responde a los inhibidores de la calcineurina, pero algunos casos son multirresistentes.
  • Las causas monogénicas representan hasta un tercio de los casos de resistencia a los esteroides.

Conclusiones:

  • El tratamiento del síndrome nefrótico requiere un control cuidadoso para prevenir complicaciones agudas y minimizar los efectos secundarios a largo plazo.
  • Los agentes conservadores de esteroides son cruciales para el manejo de los casos recurrentes o resistentes.
  • Comprender la fisiopatología subyacente es clave para mejorar los resultados, ya que algunos pacientes experimentan la enfermedad en la edad adulta.