Nephrotic Syndrome and its Serious Effects

Urine examination shows critical abnormalities in nephrotic syndrome. The urine may froth if passed in a container or if shaken in a test tube. The dipstick test always shows extensive excretion of protein in urine. Total excretion of protein per day should be measured in 24-hour's collection of urine. The nephrotic syndrome is the consequence of prolonged massive proteinuria (excretion of protein in urine). The proteinuria exceeds 3.5 g/24-hours in adults or 50 mg/kg body-weight in children. Nephrotic syndrome is characterized by proteinuria, hematuria (blood in urine), hypertension (high blood pressure), oliguria (low output of urine per day), edema (swelling: apparently suborbital puffy eyes) and diminished renal function. Urine may be brown or red. Sodium (Na⁺) retention, increased circulating blood volume and hypertension (high blood pressure) may lead to cardiomegaly (enlargement of heart). Nephrotic syndrome is usually characterized by insidious onset of massive edema, proteinuria, hypoalbuminemia (low level of albumin in blood) and hyperlipidemia (high level of cholesterol in blood). There could be massive retention of sodium (Na⁺) and a tendency to excessive potassium (K⁺) loss. Serious ill effect of the nephrotic syndrome could be a tendency towards hypercoagulability (blood clotting disorder) which may lead to venous or arterial thrombosis and embolism. Susceptibility to chest (lung) infections may increase due to decreased immunoglobulins' level in blood. Serum calcium (Ca⁺⁺) level could be low as this is related to the level of albumin in blood. Dysfunction of proximal tubules of kidneys may cause glycosuria (excretion of glucose/sugar in urine) or aminoaciduria.

Physiology of Sweating or Hidrosis

Sweating or hidrosis is a normal phenomenon. Considerable quantities of water, chloride, sodium and potassium may be lost in the sweat. There are two type of sweat: a) insensible sweat and b) sensible sweat. Insensible sweat continuously evaporates from our body under all conditions and about 500-600 ml of water is lost daily in an adult. Sensible sweat is secreted when body temperature rises due to exercise, hard labour or due to environmental factors. Sensible sweat may contain 25 to 90 milli-Equivalent (mEq) of chloride per litre. The average amount of chloride lost is about 45 mEq per litre. We compensate the loss of water through drinking water. However, if electrolytes are not taken with water the chloride level in blood/plasma may fall. This condition may be found in industrial workers, miners, labourers and athletes. One may suffer from muscular cramps due to deficiency of sodium and potassium a condition known as miners' cramps as it occurs frequently in miners as they loose electrolytes due to hyper-hidrosis or excessive sweating.

Work and exercise related hyper-hidrosis or excessive sweating is normal but unconditional hyper-hidrosis may cause emotional problems. Sweat is excreted through the sweat glands present all over the body. The cause of excessive sweating is unknown but it results due to over activity of sweat glands. There is individual variation in the intensity of sweating. Some people may also complain of sweat with bad odour or bromhidrosis. Bromhidrosis is caused by the decomposition of biological substances present in the sweat by the bacteria. Hyper-hidrosis may be generalized or continuous phenomenon or may be localized. Imbalance in the body temperature due to life style, fever, diabetes, obesity or intake of certain drugs may cause generalized hyper-hidrosis or excessive sweating. Localized hyper-hidrosis on palms and/or soles may be caused by emotional disturbances or stress or after eating certain food stuffs. Protein rich foods may help control hyper-hidrosis. Use deodorants for bromhidrosis or consult your physician. Some people my also have colored sweat or chromhidrosis. In cases of chromhidrosis saliva and urine may also be colored. Chromhidrosis may be occupation associated or food or drug associated. Change in eating habits and occupation may help overcome the problem of chromhidrosis. Use of deodorant soaps may help reduce the problem of bromhidrosis. Our kidneys play a vital role in the management of cation-anion balance and acid-base balance in our body.