Nephrotic syndrome Flashcards
What is nephrotic syndrome
When the basement membrane in the glomerulus becomes inflamed and highly permeable to protein
Common age for nephrotic syndrome
2-5 years
Presentation of nephrotic syndrome
Frothy urine, generalised oedema, pallor, triad, possible deranged lipid profile, high BP, hypercoagulability
Classic triad of nephrotic syndrome
Low serum albumin, high urine protein content and oedema
Causes of nephrotic syndrome
Minimal change disease in 90% in children under 10.
Occuring in isolation without any clear cause
Secondary causes of nephrotic syndrome
Intrinsic kidney disease such as focal segmental GS, membranoproliferative GN.
Systemic illness such as HSP, diabetes.
Infections such as HIV, hepatitis and malaria
Key management of nephrotic syndrome
Steroids for 4 weejs of high dose then gradually weaned off over folowing 8 weeks - prednisolone
Secondary managements of nephrotic syndrome
Low salt diet, diuretics for oedema, albumin infusions in severe hypoalbuminaemia, antibiotic prophylaxis in severe cases
Management in steroid resistant children
ACEI and immunosuppressants such as cyclosporine, tacrolimus or rituximab
Complications of nephrotic syndrome
Hypovolaemia, thrombosis, infection, hypercholesterolaemia, acute or chronic renal failure and relapse
What is minimal change disease
Minimal histological changes to the nephrological structures on light microscopy
What can sometimes preceed minimal change disease
Associated with viral upper respiratory tract infection a few weeks before
Complications of minimal change disease
Spontaneous peritonitis, thrombosis, renal damage, increased risk of infections
