Autoimmune Diseases that Attacks the Kidneys

Nephrotic syndrome (NS)

is one of the clinical manifestations of
glomerulonephritis characterized by
massive proteinuria ( of 3 - 3.5 g /
day or protein creatinine ratio in urine
when> 300-350 mg / mmol),
hypoalbuminemia (<25 g / l) ,
hypercholesterolemia (total
cholesterol> 10 mmol / L), and clinical
manifestations of peripheral edema.

Etiology
primary glomerulonephritis and
secondary to infection, malignancy,
connective tissue disease (connective
tissue disease), drugs or toxins, and
due to systemic disease

Epidemiology
All age (mostly age 2-7th)
Man:woman = 2:1

Patophysiology
There antigen from outside the body
into the bloodstream bound by
antibodies forming antigenantibody complexes can not be
destroyed by macrophages and other
antigen- antibody complex
settles in the kidneys ( epithelium )
inflammation glomerulonephritis
( nephrotic syndrome )

Signs and Symptoms

anorexia , weakness , foamy urine
( due to the high concentration of
urine ) . Fluid retention causes
shortness of breath ( pleural
effusion ) , oligouri , arthralgia ,
orthostatic hypotension , and pain in
the abdomen ( ascites ) .

Diagnosis
Based on clinical and laboratory
examinations in the form of massive
proteinuria > 3.5 g / 1.73 m2 body
surface area / day ) , hypoalbuminemia
< 3 g / dl , edema , hiperlipideia ,
lipiduria , and hypercoagulability

Examinations
Urinalisys
+3/+4

Examination of urine sediment

Examination of the sediment will provide an overview oval fat bodies:
epithelial cells containing grains of fat, sometimes encountered
erythrocytes, leukocytes, hyaline piston and piston erythrocytes.

Measurement of urinary protein

Serology for infectious and immunological abnormalities
Renal ultrasound
There are signs of chronic glomerulonephritis.
Renal biopsy
Blood
Ureum, creatinin

Therapy
Corticosteroid therapy
adult prednisone / prednisolone 1-1.5
mg / kg body weight / day for 4 8minggu
Proteinuria
ACE inhibitor
Edema
Diuretic

Prognosis
Based on the etiology. Complete remission
can occur with or without corticosteroids.
The prognosis may worsen due to
(1)an increased incidence of kidney failure
and secondary complications of SN,
including thrombotic episodes and
infections, or
(2)treatment-related conditions, such as
infection complications from giving
imunosupressive