Nephrotic Syndrome: Inflamed is No Game
This research is being submitted on March 7, 2014, for Kara Wall’s NUR1470C Maternal Child Nursing Course.
Nephrotic Syndrome: Inflamed is No Game
In nephrotic syndrome, it is essential to understand the function and inner workings of the kidneys. The human body requires blood to be circulated in order for organs and tissues to be perfused. The perfusion of blood is enriched with products such as plasma and cells, used to keep the body functioning. Once the products are used to their capacity they need to filtered out and become waste products to be excreted. A portion of these waste products get excreted through the kidneys. The kidneys filter blood and excrete urine (Smith, 2013). Blood and its products pass into the kidney through the renal artery and returns through the renal vein. Inside the kidney; into the nephrons, the blood fills into capillaries (the glomerular membranes) and filtered into Bowman's capsules removing water, urea, and creatinine (by-products of protein) from the blood. The fluid is then passed through the coiled part of the nephron; so that glucose cannot escape into the urine, and is then concentrated by the Loop of Henle. The fluid becomes classified as urine as it is excreted into the ureters, filling the bladder, and exiting the body during urination (Adler, 2012, p.24).
Nephrotic syndrome occurs when the kidneys are inflamed and, the glomeruli within the nephron have a “defect” which causes them to become extremely permeable. The glomeruli have membranes that allow the right amount of space for water and small molecules to pass through the membrane (Sommers, 2011, p.2). When the glomeruli are extremely permeable; products and large molecules pass through the glomerular membrane instead. One of these “unwanted” products that pass through is protein and is excreted into the urine; proteinuria. Serum albumin; the blood plasma protein, leaks into the capillaries and is excreted, causing hypoalbuminemia. Hyperlipidemia; high amounts of fats, cholesterol, and triglycerides in the blood, are not filtered because of the low pressure in the capillary beds from hypoalbuminemia (Adler, 2012, p.25). Accompanying the three major findings of nephrotic syndrome; proteinuria, hypoalbuminemia, and hyperlipidemia, is edema. Edema is swelling that can occur in the face; around the eyes, in the extremities, the abdomen, and/or the genital area. The swelling is due to “ﬂuid leaks into the interstitial spaces, collecting into body cavities” (Sommers, 2011, p.717).
The classification of nephrotic syndrome depends on when the symptoms occur; Congenital, primary, or secondary. Any form of nephrotic syndrome is characterized by the exacerbation and remission of symptoms. Congenital nephrotic syndrome is where the child is born with the symptoms. Nephrotic syndrome is an autosomal recessive trait which means that both parents must carry the gene in order for it to be passed to the child (Perry, 2010 p.1535). Idiopathic; or primary, known distinctly as “childhood nephrosis”, or “minimal-change nephrosis” is characterized as a “result of a renal disease” occurring between the ages of two and seven. Secondary nephrotic syndrome occurs when there is a clinical manifestation of a disease that has a systemic effect on more than one part of the body (Perry, 2010 p.1536).
The diagnosis of nephrotic syndrome in children; once the clinical findings have been determined, diagnostic tests that are ordered by a pediatrician. A urinalysis is collected to determine the amount of protein in the urine. A blood draw is done to see the amount of plasma protein and albumin, as well as, the creatinine and cholesterol levels in the blood. GFR stands for glomerular filtration rate; this is an estimate on how well the kidneys are functioning as determined by how fast they filter out urine (Jaffe & Schub,2013, p.2). The most accurate...
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Jaffe, S., & Schub, T. (2013, December 20). Nephrotic Syndrome in Children. Nursing Reference Center (Database). Retrieved March 1, 2014, from http://web.b.ebscohost.com.
Perry, S. E. (2010). Maternal child nursing care. Maryland Heights, Mo: Mosby Elsevier.
Smith, B. (2013, January 1). Nephrotic Syndrome in Adults - National Kidney and Urologic Diseases Information Clearinghouse. Retrieved March 1, 2014, from http://kidney.niddk.nih.gov/kudiseases/pubs/nephrotic/
Sommers, M.S. (2011, January 12). Nephrotic Syndrome. Nursing Reference Center (Database). Retrieved February 25, 2014, from http://search.ebscohost.com/login.aspxdirect =true&db=nrc&AN=2011533344&site=nrc-live
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