Nephrotic and Nephritic Syndromes Flashcards
What are the clinical findings of nephrotic syndromes?
Massive proteinuria (>3.5 g/day), hypoalbuminemia (peripheral edema), hypogammaglobulinemia (increased risk of infections), hypercoagulable state (due to loss of anti-thrombin III), and hyperlipidemia and hypercholesterolemia.
What is selective protenuria in regards to Minimal Change Disease?
Only albumin is lost, not immunoglobulins.
What is the most common cause of nephrotic syndrome in Hispanics and African Americans?
Focal segmental glomerulosclerosis (FSGS)
What else is FSGS associated with?
HIV, heroin use, and sickle cell.
What is the most common nephrotic syndrom in Caucasian adults?
Membranous nephropathy.
What else is membranous nephropathy associated with?
SLE, HBV/HCV, and drugs (NSAIDs and penicillamine).
Where is the location of the IC deposition in membranous nephropathy?
Subepithelial (beneath the podocyte, contributes to the spike and dome EM appearance).
Where is the location of the IC deposit in type I membranoproliferative glomerulonephritis?
Subendothelial.
Where is the location of the IC deposit in type II membranoproliferative glomerulonephritis?
Intramembranous.
What is type I membranoproliferative GN associated with?
HBV/HCV.
What is type II membranoproliferative GN associated with?
C3 nephritic factor (an auto-antibody that over activates C3 convertase).
Do MCD and FSGS have immune deposits?
No (won’t show up on immuno-fluorescence). Membranous nephropathy and membranoproliferative GN do and will have a granular IF.
Is membranoproliferative GN nephrotic or nephritic?
It can be either nephrotic, nephritic, or both.
If a patient with HCV has nephritic syndrome what could it be?
Type I membranoproliferative GN or mixed cryoglobulinemic GN.
If a patient with HCV has a nephrotic syndrome what could it be?
Membranous nephropathy.
