Cholemic nephrosis is a medical condition that refers to the presence of nephrotic syndrome that occurs as a result of cholestasis or the impairment of bile flow. Nephrotic syndrome is a group of symptoms characterized by the abnormal leakage of large amounts of protein into the urine, leading to proteinuria, hypoalbuminemia (low levels of albumin in the blood), edema, and high cholesterol levels.
In the case of cholemic nephrosis, the condition is specifically caused by cholestasis, which refers to the disruption of bile flow from the liver to the small intestine. This can occur due to various reasons such as liver diseases, gallstones, or obstruction of the bile ducts. As a consequence, the accumulation of bile acids and products in the bloodstream damages the glomeruli, which are tiny blood vessels responsible for filtering waste products and excess fluids from the blood.
The damage to the glomeruli impairs their ability to retain proteins, resulting in their leakage into the urine. This loss of proteins, including albumin, contributes to hypoalbuminemia, leading to a decrease in the oncotic pressure in the blood vessels and subsequent edema formation. Furthermore, the liver's impaired function in cholestasis disrupts the metabolism of lipids, causing elevated levels of cholesterol in the blood.
Treatment for cholemic nephrosis typically involves addressing the underlying cause of the cholestasis, such as liver disease or bile duct obstruction. This may include medications to improve liver function, surgical intervention to remove gallstones or obstructions, or other specialized treatments, depending on the specific case. Additionally, management of symptoms such as proteinuria and edema may involve medications to reduce protein leakage, diuretics to control fluid retention, and dietary adjustments to regulate cholesterol
