Renal interstitial edema

Introduction Renal interstitial refers to connective tissue, nerves, blood vessels, lymphatic vessels, etc. in the kidney, distributed between the nephron and the collecting tubule. Excessive body fluids accumulate in the interstitial space or body cavity called edema. Renal interstitial edema refers to the accumulation of excessive body fluids in the renal interstitium. It is also one of the common symptoms of kidney disease. Edema caused by heart disease is called cardiogenic edema or cardiac edema. Edema caused by liver disease is called hepatic edema or hepatic edema. The edema caused by kidney disease is called nephrogenic edema. Nephrogenic edema is a kind of systemic edema. It is a common symptom of glomerular disease. It is caused by kidney disease, which causes water and sodium retention in the body, causing edema in different degrees of tissue loosening.

Cause

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.

an examination

Related inspection

Urine routine urine inclusion body examination

Detailed systemic examinations should be performed on patients with edema, as many systems, organs, and tissue disorders can cause edema. A systemic examination helps to understand the source and characteristics of edema and is helpful in diagnosis and differential diagnosis. Sitting breathing, heart rate or pulse increase, heart enlargement, ventricular contraction or diastolic dysfunction, increased central venous pressure, large vein congestion, jugular vein engorgement, enlarged liver and spleen, etc., suggesting the presence of heart failure, edema is caused by Caused by heart disease, spleen congestion and swelling, abdominal collateral venous venous engorgement, portal hypertension combined with ascites, suggesting cirrhosis; if the expression is dull, hair is scarce, rough skin, suggesting hypothyroidism, that is, edema may. In addition, liver disease patients and kidney disease patients also have different aspects of face and skin pigmentation.

Differential diagnosis

(1) Cardiac edema: In the case of right heart dysfunction, exudative or constrictive pericarditis, edema is caused by increased venous pressure in the systemic circulation and increased capillary filtration pressure. Cardiac edema is characterized by edema that first occurs in the ptosis, often throughout the body from the lower extremities, and ascites or pleural effusion can occur in severe cases. Edema is formed at a slower rate. The edema is solid and less mobile. The main basis for the diagnosis of cardiogenic edema is the history and signs of heart disease. Determination of a significant increase in venous pressure is an important indication for diagnosis.

(2) Hepatogenic edema: cirrhosis often has mild edema of the lower extremities before the appearance of ascites, which first occurs in the ankle and gradually spreads upward. The head and face and upper limbs are often edema. Ascites and pleural effusion occur in severe cases. A variety of chronic liver disease history and signs of liver damage and laboratory indicators are the basis for diagnosis.

(3) dystrophic edema: chronic consuming disease, chronic nutritional deficiency, protein loss gastrointestinal disease, severe burns caused by hypoproteinemia, vitamin B1 deficiency, etc. can produce edema. Tissue relaxation caused by a decrease in subcutaneous fat and a decrease in tissue pressure increase the retention of water. Edema often spreads from the foot to the whole body.

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