FN: Nephrotic Syndrome Flashcards
Triad
Proteinuria
Hypoalbuminaemia
Oedema
Hyperlipidaemia
Triad
Proteinuria
Hypoalbuminaemia
Oedema
Hyperlipidaemia
Proteinuria levels
PCR >300mg/mM or >3g/24hrs
Hypoalbuminaemia
Oedema
Periorbital
Genital
aScites
PEripheral - often intravascularly depleted with reduced JVP )cf. CFF)
Complications
Infection: reduced Ig, reduced complement activity
VTE: up to 40%
Hyperlipidaemia: raised cholesterol adn TG
Investigations
As for GN check lipids
Biopsy:
1. Biopsy all adults
2. Steroids 1st with children: mostly minimal change disease
Secondary to
Systemic disease
1. DM: glomerulosclerosis
SLE: membranous
Amyloidosis
Types
Minimal change glomerulonephritis
Membranous Nephropathy
FSGS
Membranoproliferative/Mesangiocapillary
Minimal change glomerulonephritis epi
Commonest in children
Minimal change glomerulonephritis assoc
URTI
Minimal change glomerulonephritis biopsy
normal light micro, fusion of podocytes on EM
Minimal change glomerulonephritis Rx
Steroids
Minimal change glomerulonephritis prognosis
1% ESRF
Membranous Nephropathy epi
20-30% of adult nephrotic syndrome
Membranous Nephropathy associations
Ca: lung, colon, breast
AI: SLE, thyroid disease
Infections: HBV
Drugs: Penicillamine, gold
Membranous Nephropathy biopsy shows
subepithelial immune complex depositis
Membranous Nephropathy Rx
immunosuppresion if renal failure declines
Membranous Nephropathy prognosis
40% spontaneous remission
FSGS ep
Commoner in Afro-caribeens