Nephrotic and Nephritic Syndrome

Question 1

What is the pathophysiology of nephrotic syndrome?

Answer 1

• Derangement of glomerular capillary walls causing increase protein permeability
• Can be in the endothelium, glomerular, or visceral epithelial cells and the defect can be structural or physiochemical

Question 2

What are the features of nephrotic syndrome?

Answer 2

• Massive proteinuria (more than 3.5g per day)
• Hypoalbuminaemia
• Widespread oedema
• Hyperlipidaemia and lipiduria
• Prothrombotic state

Question 3

What are the causes of nephrotic syndrome in kids?

Answer 3

- Primary Renal disease
	○ Minimal change disease
	○ Focal segmental glomerulosclerosis
	○ Membranoproliferative 
	○ Membraneous glomerulopathy 
	○ Other proliferative glomerulonephritis
- Systemic
	○ SLE
	○ Drugs - NSAIDs
	○ Infections
	○ Malignant - carcinoma, lymphoma 
	○ DM
	○ Amyloides
	○ Other

Question 4

What is the pathophysiology of nephritic syndrome?

Answer 4

• Inflammation and proliferation of glomerular cells

Question 5

What are the features of nephritic syndrome?

Answer 5

• Haematuria
• Red cell casts in urine
• Azotemia
• Oligouria
• Mild to moderate hypertension
• Can also get proteinuria and oedema but not as severe as in nephrotic