Nephrotic Syndrome

Question 1

what is nephrotic syndrome

Answer 1

Nephrotic syndrome is a clinical syndrome that arises secondary to increased permeability of serum protein through a damaged basement membrane in the renal glomerulus

Question 2

what 3 features is nephrotic syndrome characterised by

Answer 2

proteinuria, hypoalbuminaemia, oedema

hypercholesterolaemia is also a common feature

Question 3

aetiology of nephrotic syndrome

Answer 3

most common cause is GLOMERULONEPHRITIS in children and in adults, glomerulonephritis and diabetes mellitus

other causes include:
diabetes mellitus, SCA, amyloidosis, malignancies (lung and GI adenocarcinomas), drugs (NSAIDs), Alports syndrome, HIV

Question 4

presenting symptoms of nephrotic syndrome

Answer 4

Family history of atopy (in those with minimal change glomerulonephritis)

Family history of renal disease

Swelling of face, abdomen, limbs, genitalia (due to hypoalbuminaemia)

Symptoms of the underlying cause (e.g. SLE)

Symptoms of complications

Question 5

what are some signs of nephrotic syndrome

Answer 5

Oedema: periorbital, peripheral, genital

Ascites: fluid thrill, shifting dullness

Question 6

what investigations will be done for nephrotic syndrome

Answer 6

Bedside investigation include urine dipstick which reveals proteinuria. Urine analysis reveals a raised albumin creatinine ratio.

Renal biopsy is indicated in all adults but should only be done in children with an atypical presentation (e.g. steroid unresponsive, haematuria, under 1 years old or over 12 years old).

tests to identify cause; e.g. testing for diabetes etc

Question 7

management of nephrotic syndrome

Answer 7

high dose steroids

Question 8

what are some complications of nephrotic syndrome

Answer 8

infection (loss of immunoglobulins),

venous thromboembolism (urinary loss of antithrombin III)

hyperlipidaemia (increased hepatic production of lipids)