Why Acute Kidney Failure in Nephrotic Syndrome

Nephrotic syndrome is caused by many reasons and it is a glomeurlar disease which is mainly characterized by increased glomerular filtration membrane and decreased glomerular filtration rate. Nephrotic syndrome will cause many complications such as infection, high condensation state, venous thrombosis, acute renal failure, declined function of renal tubules, metabolic disorders of bone and calcium,etc.

Acute renal failure is the most serious complication of nephrotic syndrome and usually dialysis will be needed.

The common reasons of acute kidney failure are as follows:

1. Hemodynamic change. Nephrotic syndrome often has hypoalbuminemia and vascular lesions, especially among the elderly patients, renal arteriosclerosis is often accompanied. They are very sensitive to the decrease of blood volume and blood pressure. In case of physical trauma, ascites, diuresis, anti-hypertension medicines or loss of body fluids due to acute blood loss, vomiting, diarrhea, the blood pressure will be further lowered and this will cause sharp fall of renal perfusion and glomerular filtration rate (GFR). And the acute blood loss will cause swelling, degeneration and necrosis of the epithelia cells and lead to acute kidney failure.

2. Renal interstitial edema. Hypoalbuminemia can cause edema of the surrounding tissues as well as the renal interstitial and it will oppress the renal tubules and cause decrease of GFR.

3. Acute interstitial nephritis due to improper intake of medicines.

4. The formation of renal vein thrombosis in bilateral kidneys.

5. Vasoconstriction. Some patients may have increased rennin concentration in case of hypoalbuminemia and the rennin will cause renal arterioles contraction. It is more common among the elderly that have vascular lesions.

6. The concentrated protein cast will obstruct the distal renal tubules and this might be related to the mechanism of acute renal failure.

7. The extensive fusion of the glomerular epithelium foot and the disappearing of the holes will cause obvious decrease of effective filtration area.

8. Rapidly progressive glomerulonephritis.

9. Urinary tract obstruction.