Abstract | Nefrotski sindrom je obostrana glomerulopatija, a karakterizira ga povećana propusnost kapilara za proteine i lipide, hipoalbuminemija, hiperlipidemija i sklonost edemima a dijalimo ga na idiopatski i sekundarni. Bolest se može pojaviti u svim dobnim skupinama. Pacijenta se obiĉno prepoznaje po otocima oĉnih kapaka, lica i drugih dijelova kože koji su izraženiji u jutarnjim satima i ne ovise o sili teži. Uz to, može biti prisutan hidrotoraks, hidroperikard i ascites. U dijagnostici nefrotskog sindroma prvi test je analiza mokraće, a ako se u njoj pronađe znaĉajna proteinurija oznaĉena s 3+ ili 4+, može se sumnjati na ovu bolest. Kad se dijagnoza potvrdi, dodatne analize se provode kako bi se utvrdilo je li nefrotski sindrom idiopatski ili sekundarni. Idiopatski nefrotski sindrom ukljuĉuje: bolest minimalnih promjena, mezangioproliferativni glomerulonefritis, fokalna glomerularna skleroza, membranska nefropatija te membrano-proliferativni glomerulonefritis. Sekundarni nefrotski sindrom može nastati kao posljedica druge bolesti, a razlozi su brojni. Lijeĉenje nefrotskog sindroma je složeno, dijeli se na simptomatsko i specifiĉno, ovisi o uzroku bolesti i ukljuĉuje lijeĉenje osnovne bolesti, kontrolu krvnog tlaka i uzimanje lijekova koji smanjuju gubitak proteina kroz mokraću. Ako se bolest ne lijeĉi, može dovesti do trajnog oštećenja bubrega i drugih komplikacija. Stoga je prevencija i rano otkrivanje kljuĉno za zaštitu funkcije bubrega i osiguravanje kvalitetne zdravstvene skrbi za pacijente s ovom bolesti. Medicinska sestra ima važnu ulogu u zbrinjavanju bolesnika s nefrotskim sindromom, jer mora poznavati razvoj i tijek bolesti, dijagnostiku i lijeĉenje. |
Abstract (english) | Nephrotic syndrome is a bilateral glomerulopathy characterized by increased permeability of capillaries for proteins and lipids, hypoalbuminemia, hyperlipidemia and a tendency to edema, and we divide it into idiopathic and secondary. The disease can occur in all age groups. The patient is usually recognized by swelling of the eyelids, face and other parts of the skin, which are more pronounced in the morning hours and do not depend on the force of gravity. In addition, hydrothorax, hydropericardium and ascites may be present. In the diagnosis of nephrotic syndrome, the first test is a urine analysis, and if significant proteinuria marked with 3+ or 4+ is found, this disease can be suspected. Once the diagnosis is confirmed, additional tests are performed to determine whether the nephrotic syndrome is idiopathic or secondary. Idiopathic nephrotic syndrome includes: minimal change disease, mesangioproliferative glomerulonephritis, focal glomerular sclerosis, membranous nephropathy and membrano-proliferative glomerulonephritis. Secondary nephrotic syndrome can occur as a result of another disease, and the reasons are numerous. The treatment of nephrotic syndrome is complex, it is divided into symptomatic and specific, it depends on the cause of the disease and includes treatment of the underlying disease, control of blood pressure and taking drugs that reduce protein loss through urine. If the disease is not treated, it can lead to permanent kidney damage and other complications. Therefore, prevention and early detection are key to protecting kidney function and ensuring quality healthcare for patients with this disease. Nurses have an important role in the care of patients with nephrotic syndrome, because they must know the development and course of the disease, diagnosis and treatment. |