Dyslipidemias in Nephrotic Syndrome: Mechanisms and treatment Essay

Dyslipidemias in Nephrotic Syndrome: Mechanisms and treatment Essay

Differential Diagnosis

The differential diagnoses for this patient are nephrotic syndrome, acute kidney injury, and acute glomerulonephritis. Nephrotic syndrome is kidney disease characterized by proteinuria, low serum albumin, and elevated creatinine levels (Agrawal, et al, 2018). Primary nephrotic syndrome is caused by body’s autoimmune reactions such as minimal change nephropathy and hereditary nephropathy. Secondary causes are diabetes mellitus and viral infections. Clinically, it presents with fatigue, loss of appetite, nausea, vomiting, edema, foamy urine, and hematuria. Dyslipidemias in Nephrotic Syndrome: Mechanisms and treatment Essay

Acute kidney injury is an abrupt or rapid decline in renal filtration. It is characterized by elevated createnine level, decreased urine output, elevated serum urea, and urine proteins loss (Levey, et al, 2017). For this patient, the cause of acute kidney injury could be dehydration due to the continuous vomiting, acute infection, or a nephrotoxic drug reaction. Dyslipidemias in Nephrotic Syndrome: Mechanisms and treatment Essay

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Acute glomerulonephritis is a renal disease in which immunologic mechanism triggers inflammation and proliferation of the glomerular tissue (Bhalla, et al, 2019). It is characterized by a sudden onset hematuria, proteinuria, and red blood cell cast in urine. The clinical presentations are generalized body malaise, edema, nausea, vomiting, and hypertension. The actual diagnosis is nephrotic syndrome Dyslipidemias in Nephrotic Syndrome: Mechanisms and treatment Essay

Management Plan

Pharmacological

Furosemide 80mg intravenously three times a day

Spironolactone 25mg per oral once a day

Heparin 5000 IU subcutaneously twice a day

Prednisone 200mg once a day per oral for one week

Enalapril 10mg per oral once a day

Non Pharmacological

Take meals with adequate amounts of calories and proteins but low salt. Patient to engage in physical activities to prevent blood clots.

I need help with the diagnosis and differential diagnosis of this presenting symptom “I went to see my doctor this morning because I have been feeling bad for the past few days. I’m tired, with nausea & vomiting. Well, he examined me and ordered some labs, and then told me that “kidneys are failing,” something about a big change in my creatinine and that I needed to come to the emergency department. He told me to bring the test results here with me. [Test results today: creatinine 3.2 mg/dL; 1 month ago Test results 1.1 mg/dL; urine protein = 400 mg microalbuminuria] Do you understand what all that means? I sure don’t!

References

Agrawal, S., Zaritsky, J. J., Fornoni, A., & Smoyer, W. E. (2018). Dyslipidaemia in nephrotic syndrome: mechanisms and treatment. Nature Reviews Nephrology, 14(1), 57.

Bhalla, K., Gupta, A., Nanda, S., & Mehra, S. (2019). Epidemiology and clinical outcomes of acute glomerulonephritis in a teaching hospital in North India. Journal of family medicine and primary care, 8(3), 934.

Levey, A. S., & James, M. T. (2017). Acute kidney injury. Annals of internal medicine, 167(9), ITC66-ITC80. Dyslipidemias in Nephrotic Syndrome: Mechanisms and treatment Essay