Nephrotic Syndrome Flashcards
what is Characteristic of Nephrotic Syndrome ?
Loosing TONS of protein!
What is the Pathophysiology of Nephrotic Syndrome ?
- ) its an inflammatory response in the glomerulus
- ) Big holes form, so protein starts leaking out in the urine (proteinuria)
- ) Now the client is Hypoalbuminemic (low albumin in blood)
- ) Without albumin you can’t hold on to fluid in the vascular space, so it goes into the tissues
- ) Client is now edematous, since all the fluid is going out into the tissue
- ) this causes the circulating blood volume to decrease
- ) the kidneys sense the decreased volume and they want to help replace it
- ) The renin-angiotensin system kicks in
- ) Aldosterone is produced and causes the retention of sodium and water
- ) However there is still no albumin in the vascular space to hold onto the fluid
- ) So, the fluid goes into the tissues (3rd spacing)
- Total body edema = Anasarca -
What is total body edema called ?
Anasarca
What are problems associated with Protein loss ?
- Blood clots (thrombosis)
- High cholesterol and triglycerides
Why are Blood clots (thrombosis) a problem associated with protein loss ?
B/c they are loosing proteins that normally prevent their blood from clotting
- Without these proteins, the blood can clot and put them at risk for thrombosis
Why is High cholesterol and triglycerides a problem associated with protein loss ?
The liver compensates by making more albumin causing an increased release of cholesterol and triglycerides
Causes of nephrotic syndrome are ___________, but have been related to some things
Idiopathic
Causes of Nephrotic syndrome have been related to what types of things ?
- Bacterial or viral infections
- NSAID’s
- Cancer & genetic predispositions
- Systemic diseases such as…
- Lupus
- Diabetes
What are the signs & symptoms of Nephrotic Syndrome ?
- MASSIVE proteinuria
- Hypoalbuminemia
- Edema (anasarca)
- Hyperlipidemia
What are the Tx’s for Nephrotic syndrome ?
- Diuretics
- ACE inhibitors
- Prednisone
- Cyclophosphamide
- Diet alterations
- Lipid lowering drugs (for hyperlipidemia)
- Anticoagulation therapy
- Dialysis
Why are ACE inhibitors used in the Tx for Nephrotic syndrome ?
To block aldosterone secretion
Why is Prednisone used in the Tx for Nephrotic syndrome ?
To decrease inflammation
Why are Cyclophosphamide’s used in the Tx for Nephrotic syndrome ?
To decrease the body’s immune response
- shrinks holes so protein can’t get out
- Immunosuppressed
- Infection = a major complication of Nephrotic syndrome
What is a major complication of Nephrotic syndrome ?
Infection
d/t use of Cyclophosphamide’s
What does a Diet look like for a client with Nephrotic syndrome ?
- Moderate protein (1 to 2 grams/kg/day)
- Decreased sodium
- Client can become malnourished fast
