Nephro

Question 1

NEPHROTIC SYNDROME - fx

Answer 1

• > 3g/day proteinuria
• Hypo-albuminaemia
• Oedema
• Hyperlipidaemia
• Thrombotic dis

Question 2

NEPHROTIC SYNDROME - dis

Answer 2

1. FSGS
   - Primary (immune med) or 2ndary (stress eg BMI, infection, meds)
   - Differentiate for Rx options & if considering Tx
   - 50% ESKD in 10y (Primary can return if Tx)
   - Rx primary: CS; IS (calcineurin-inh eg Cyclo/Tacro) + ACE/ARB
   - 2ndary: Rx underlying cause
   (2. Diabetic)
2. Membranous
   
   • 75% idiopathic;
   • 2ndary (AI/systemic dis, infection, drugs, CANCER - solid organ)
   • Rule of 1/3 (spontaneously remit v relapse v ESKD)
   • PLA2R (monitor for Rx choice/response)
   • AC if hypoalbuminaemia or RF for VTE!
   • ACE/ARB, lipid lowering, (IS if underlying dis appropriate)
3. Minimal change (usu kids)
4. Amyloidosis/LCDD