Wednesday, November 18, 2015

Why Patients Who Have IgA Nephropathy Have Symptom of Edema?

IgA nephropathy with hematuria as the main clinical manifestations and identification of indicators to identify indicators of proteinuria is secondary IgA nephropathy.

Depending on the pathogenesis of the renal edema divided clinically into two categories:
1, nephritis edema: mainly seen in acute nephritis, or part of rapidly progressive glomerulonephritis, chronic glomerulonephritis and other glomerular diseases. Edema is mainly due to:
① glomerular filtration rate, renal exclusion of water, sodium reduction and edema;
② ball - tube Imbalance: acute inflammation of glomeruli, glomerular filtration rate was significantly lower, but the tubular reabsorption is relatively good, the ball - loss of balance between the tubes, sodium and water reabsorption in the renal tubules relative increase caused edema;
③ capillary hydrostatic pressure increased, the capillaries toward excessive interstitial fluid caused the edema;
When ④ acute nephritis, some patients due to increased blood volume, blood pressure and other causes of congestive heart failure, increased water and sodium retention.

2, nephrotic edema: usually occurs in primary glomerular nephropathy and other various causes of nephrotic syndrome. The main mechanism of edema are:
① plasma colloid osmotic pressure: nephrotic proteinuria caused a lot of hypoproteinemia, caused by the plasma colloid osmotic pressure reduced, so that the body fluid capillary filtration increases, a significant reduction in inter-organizational recovered from body fluids, and ultimately the formation of edema.
② effective hypovolemia: plasma extravasation make effective hypovolemia, stimulate intravascular volume receptors, activation of the renin - angiotensin - aldosterone system, antidiuretic hormone secretion, natriuretic hormone secretion, tubular reabsorption of sodium increase, further exacerbating water and sodium retention, causing edema.

IgA nephropathy with hematuria as the main clinical manifestations and identification of indicators to identify indicators of proteinuria is secondary IgA nephropathy. However, once the body proteinuria, so the water in the body can not be well absorbed into the blood vessel, the water appears to occur between the tissue penetration of the situation, this time, the patient will appear lower extremity edema, or swelling of the face, mainly based facial swelling and lower limb edema. For the already diagnosed as IgA nephropathy patients, edema is a manifestation of the emergence of glomerular and tubular function decline.


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