Diuretic therapy plays an important role in nephrotic syndro2017-02-20 14:01
1 nephrotic syndrome hypoalbuminemia and proteinuria of loop diuretics are inhibited, and the patients with distal renal tubular sodium reabsorption is active, diuretic resistance. Urinary albumin > 4g/ L, loop diuretic dose should be increased by 2 ~ 3 times in order to have a sufficient amount of free drugs play a role. Combined with albumin can enhance diuresis effect.
2 combined use of thiazide can increase efficacy. Diuretic should not be too fast, otherwise the blood volume is reduced rapidly, blood concentration, can induce acute renal failure and embolism and other complications. The nephrotic syndrome with nephrotic syndrome, in principle, do not use thiazide diuretics, which can cause further damage to renal function.
3 loop diuretics furosemide can still be used in renal damage, but the degree of renal damage severe diuretic effects.
4 diuretics can lead to electrolyte disorder and hyperuricemia, and thiazides and loop diuretics often induced by hyperglycemia, the renal insufficiency, diuretics should be gradually increased.
5 of the height edema with pleural effusion or ascites and good renal function, often accompanied by increased aldosterone, often can use more than two diuretics such as furosemide and spironolactone. At the same time to reduce proteinuria, according to clinical or pathological type, with the use of hormone or immunosuppressive agents (such as Cellcept).
6 nephrotic syndrome associated with hypertension, edema subsided but the blood pressure is still not normal, usually using hydralazine, propranolol and diuretics, the so-called standard triple therapy.