2.4. Glomerulonephritis - Nephrotic Syndrome Flashcards
What are the three conditions which cause Nephrotic Syndrome?
- Minimal Change Disease
- Focal Glomerulosclerosis
- Membranous Nephropathy
What is the commonest cause of Nephrotic Syndrome in children?
Minimal Change Disease
What does Focal Glomerulosclerosis cause?
Death to Podocytes, which can progress to renal failure over 2-3 years
How severe are the Nephrotic Syndrome Symptoms caused by Focal Glomerulosclerosis?
Severe
Does a transplant cure Focal Glomerulosclerosis?
No, it can re-occur after transplantation
What is the commonest cause of Nephrotic Syndrome in Adults?
Membranous Nephropathy
What is the Aetiology of Membranous Nephropathy?
This is unknown but malignancy is suspected
What is the pathology of Membranous Nephropathy?
- The Basement Membrane is abnormally thickened due to the Deposition of IgG on the Basal Lamina (closest to the Podocyte)
- The IgG cannot pass through here however to get into the Urine so holes are punches in the Punched in the Basal Lamina / Podocyte due to the Compliment Cascade C3
- This causes a leaky filter and Nephrotic Syndrome can occur
What are the Clinical Features of Nephrotic Syndrome?
- Oedema
- Proteinuria
- Hypoalbuminaemia
- Hyperlipidaemia
- Hypercoagulability
- Increased Risk of Infection
In what condition would a Sudden Onset of Oedema be associated with?
Minimal Change Disease
Why does the Oedema / Hypoalbuminaemia occur?
Due to the loss of Albumin, which maintains the Oncotic Pressure, through the holes punched in the Glomeruli
Why does Proteinuria occur?
Do to protein leaking through the Glomeruli Filter into the Tubule
Why does Hyperlipidaemia occur?
- The liver tries to compensate for the loss of Albumin
2. As a side effect there is an increase in the production of Lipids
Why does Hypercoagulability occur?
Due to the loss of Anti-Clotting Factors
What is the Significant Risk associated with Hypercoagulability?
DVT
