Nephrotic syndrome

Question 1

Pathophysiolgy of nephrotic syndrome?

Answer 1

Issue with filtration barrier with podcytes being primarily implicated which leads to leaking of protein into urine.

3 main causes:
- Minimal change disease
- Focal segmental glomerulosclerosis
- Membranous nephropathy

Question 2

What is minimal change disease?

Answer 2

Normal experience on microscopy but there is abnormal function

Diagnosis by biopsy

Treat with steroids(prednisolone)

Question 3

What is focal segmental glomerulosclerosis?

Answer 3

Commenest cause seen on renal biopsy

Canbe idiopathic or due to HIV, Heroin or lithium

Diagnosed by scarring of glomeruli

Give ACE - I/ARB + Steroids

Question 4

Main signs + symptoms of nephrotic syndrome?

Answer 4

Proteinuria( it can cause frothy urine)

Hypalbuminanemia ( loss of albumin in urine)

Oedema

Question 5

What is Membranous nephropathy?

Answer 5

Is immunologically mdiated

Diagnosed by renal biopsy which will show thickened glomerular basment membrane. Also App A2 receptor can be found in blood

Managed with ACE - I/ ARB + Steroids ( predisolone).