Edema with proteinuria
Introduction
Introduction Edema with proteinuria, edema with severe proteinuria is mostly renal edema. Mild proteinuria can also be seen in cardiogenic edema in addition to nephrotic edema. Edema during pregnancy, proteinuria is more common in gestational poisoning edema. In the second trimester of pregnancy, due to the enlarged uterus compressing the inferior vena cava, blood reflux is blocked, often with mild lower extremity edema, and naturally subsides after rest. If the edema does not disappear after the break, or the edema is heavier, and no other abnormal findings are found, it is called pregnancy edema.
Cause
Cause
Causes of nephrogenic edema:
1 glomerular filtration rate decreased, sodium retention.
2 The increase in systemic capillary permeability makes it easy for fluid to enter the interstitial space from the blood vessels.
3 plasma protein levels are reduced, especially albumin levels are reduced, causing a decrease in plasma colloid osmotic pressure and easy migration of water to the interstitial space.
4 The effective blood volume is reduced, resulting in an increase in secondary aldosterone, which aggravates the retention of sodium and water.
Causes of cardiogenic edema:
Cardiogenic edema is an edema caused by cardiac dysfunction.
Causes of edema during pregnancy:
In the second trimester of pregnancy, due to the enlarged uterus compressing the inferior vena cava, blood reflux is blocked, often with mild lower extremity edema, and naturally subsides after rest. If the edema does not disappear after the break, or the edema is heavier, and no other abnormal findings are found, it is called pregnancy edema. Edema during pregnancy: Some are pregnant women with weak spleen and stomach, and the diet hurts the spleen and stomach; some are pregnant women with insufficient kidney gas.
If the edema during pregnancy is mild, there will be no harm. If you are serious, you should go to the hospital.
Examine
an examination
Related inspection
Renal function test
Characteristics of renal edema:
Edema first occurs in loose areas of the tissues, such as the eyelids, face, and ankles. It is obvious in the morning, and can involve the lower limbs and the whole body in severe cases. The nature of nephrotic edema is soft and easy to move, and it is clinically depressed edema, that is, depression can be caused by pressing a local skin with a finger.
The characteristics of cardiogenic edema are:
1. The edema gradually forms, first manifested as a decrease in urine output, body weight, weight gain, and then gradually appear lower extremities and systemic edema.
2. Edema starts from the sagging part of the body and gradually develops into systemic edema. In general, the lower extremity can be depressed edema, which is most obvious.
3. Other symptoms and signs associated with right heart failure and elevated venous pressure, such as palpitations, asthma, jugular vein engorgement, hepatomegaly, and even chest and ascites.
Edema during pregnancy:
The edema starts from the ankle and gradually spreads to the calves, thighs, abdominal wall, genital area and the whole body. In severe cases, the body is swollen and may even be accompanied by ascites.
Diagnosis
Differential diagnosis
Classification of edema
According to their causes can be divided into the following categories:
(1) Cardiogenic edema: common in congestive heart failure, acute or chronic pericarditis.
(2) Nephrogenic edema: common in glomerulonephritis, pyelonephritis and nephrotic syndrome.
(3) Hepatogenic edema: common in viral hepatitis, cirrhosis and so on.
(4) dystrophic edema: common in hypoproteinemia, vitamin B1 deficiency and so on.
(5) Edema caused by connective tissue disease: common in lupus erythematosus, scleroderma and dermatomyositis.
(6) allergic edema: such as serum disease.
(7) Endocrine edema: common in Xi Han disease, hypothyroidism and Cushing's syndrome.
(8) idiopathic edema: such as functional edema.
(9) Others: anemia edema, toxic edema in pregnancy.
