The main clinical condition of acute kidney injury in nephrotic syndrome (NSAKI) is parenchymal edema of the kidney

Abstract

Onset of acute kidney injury (AKI) in nephrotic syndrome (NS) with severe edema, namely NSAKI, is often experienced. Investigation of 4 cases of NSAKI of whom we recently experienced, revealed the clinical condition seemed to be caused by kidney ischemia with kidney parenchymal edema. Increased intravascular volume occurs as a result of the renin angiotensin system activated by kidney ischemia. Therefore, there is an unbalanced clinical condition where kidney ischemia and intravascular overflow water are present at the same time.

Acute tubular necrosis caused by NSAKI may be reversible, because the pathogenesis is partial ischemia even if kidney dysfunction has continued for several months.

Therefore, it is important to reduce kidney parenchymal edema in the treatment of NSAKI by albumin intravenous infusion and the combination of diuretics.