An adolescent experiencing a vaso-occlusive crisis reports right knee pain. Which is the most appropriate intervention?

Options A (increased ability of tissue to retain fluid) and B (reduced blood pressure) are not typical signs of improvement in Nephrotic Syndrome. The primary focus is on reducing protein loss and alleviating edema.

Option C. Increased diuresis and decreased protein loss in urine.

Nephrotic Syndrome is characterized by increased urinary protein loss, resulting in hypoalbuminemia, edema, and other symptoms. Improvement in Nephrotic Syndrome is typically indicated by:

Increased diuresis: An increase in urine output suggests that the child is excreting excess fluid, which can help reduce edema (swelling).

Decreased protein loss in urine: A reduction in proteinuria (loss of protein in the urine) is a positive sign, as it indicates that the damaged kidney glomeruli are functioning more effectively in retaining protein.

Option D (decreased protein levels in serum) is also not a clear sign of improvement. While it may be related to reduced protein loss in urine, it does not directly reflect the overall improvement of the condition. Monitoring protein levels in the urine (proteinuria) is a more specific indicator of Nephrotic Syndrome management.

A.Anemia can be a common finding in nephrotic syndrome, often due to the loss of proteins like transferrin that are involved in red blood cell production, along with potential blood loss during episodes of proteinuria. The reduction in red blood cell production or anemia in nephrotic syndrome can also be exacerbated by decreased erythropoietin production.

B.Hypolipidemia is not a characteristic of nephrotic syndrome. In fact, nephrotic syndrome is associated with hyperlipidemia.

C.Hyperlipidemia is a classic feature of nephrotic syndrome. It results from an increase in the synthesis of lipoproteins by the liver as a compensatory mechanism to the loss of proteins (particularly albumin) in the urine.

D.Hypoproteinemia, specifically hypoalbuminemia, is a hallmark of nephrotic syndrome. The loss of protein (especially albumin) through the urine due to damaged glomeruli leads to decreased levels of proteins in the blood. This contributes to the characteristic edema seen in nephrotic syndrome.

E.Hypoglycemiais not typically associated with nephrotic syndrome. Instead, children with nephrotic syndrome generally do not experience significant changes in glucose metabolism. In fact, if anything, glucose levels may be slightly elevated in some cases due to stress or steroid treatment.