It is a necessary step to diagnose before treatment. The patient can not be cured of the disease, watching the nephrotic syndrome developing into kidney failure and uremia and can do nothing, those are largely because of the unclear diagnosis. Here are the items that need to be examined for nephrotic syndrome:
1. blood routine, ESR: some patients are small cell, low pigmented anemia, some cases of platelet proliferation, ESR faster.
2. urine analysis: urinary protein is often used as one of the main diagnostic criteria; for urinary protein qualitative 2+ to 4+, urinary protein / urine creatinine, >2. Red blood cell increases in urine, the majority of cases showed hyaline tube type, granular tube type and oval fat body, and occasionally the fatty duct type.
3.24h urinary protein quantification: 24 hours urine protein quantitative >3.5g.
4. liver function: with a characteristic of hypoproteinemia, serum albumin is lower than 25g/L, albumin / globulin ratio (white ball ratio), serum albumin decreased level was negatively correlated with the content of urinary protein.
5. renal function: type I nephrotic syndrome, renal function is usually normal or transient increase, type II nephrotic syndrome with varying degrees of abnormalities.
6. Blood Lipids Analysis: almost all kinds of lipoprotein components increased.
Serum triglyceride, cholesterol, low-density lipoprotein and very low density lipoprotein increases. Cholesterol in patients with type II is normal or increase mild.
7. serum protein electrophoresis: alpha 2- globulin and beta globulin elevated, while alpha 1- globulin and gamma globulin were normal or decreased.
8. immunoglobulin: IgG often decreased, while IgA, IgM and IgE usually increased.
9. rheumatism series: can have antinuclear antibody, anti -dsDNA, anti Sm antibody is positive, nephritis nephrotic syndrome CH50 can be reduced.
10. blood and urine fibrin degradation products: type I patients were normal, type II patients increased.
11. Coagulation factor: the factor IV and VI decreased, factor V and VIII, x, Fib increase.
12. pathological examination of renal biopsy
This is not required. For patients who are resistant to glucocorticoid treatment or have an unknown cause of acute progression, a viable renal biopsy is not necessary.
11 items of tests must be done by nephrotic syndrome patients