Question
Patient Gender: Zhang Jinlai. Question Description: After being diagnosed with nephropathy at Jining People’s Hospital, I have been treated for a month and showed improvement, but it has recurred several times. What is happening? What should I pay attention to?
Answer
Nephropathy is a clinical syndrome characterized by massive proteinuria (over 3.5 grams of protein in 24 hours of urine), hyperlipidemia, and various degrees of specific symptoms. It is divided into primary and secondary types, with secondary nephropathy caused by autoimmune diseases (such as systemic lupus erythematosus), diabetes, secondary infections (such as bacteria, hepatitis B virus, etc.), circulatory system diseases, and drug toxicity. In the early stages, the glomerular membrane changes are mild, and as the disease progresses, large amounts of protein are lost in the urine, which is an important cause of decreased plasma protein levels. The decrease in plasma protein levels, especially albumin, leads to a decrease in plasma colloid osmotic pressure, promoting fluid leakage from the blood vessels into the tissues and reducing effective blood volume. The mechanism of nephropathy causing hyperlipidemia is not yet fully understood. When there is a large loss of protein in the urine, the liver increases the synthesis of albumin, which also increases the synthesis of lipoproteins, one of the causes of hyperlipidemia. Additionally, a decrease in lipoprotein lipase activity may also be a factor.