Nephrotic syndrome Flashcards
How does nephrotic syndrome occur?
Basement membrane in glomerulus becomes highly permeable to protein - allows to enter urine
When does nephrotic syndrome most commonly occur>
2-5 years
Nephrotic syndrome classic triad
Low serum albumin
high urine protein content (+3 on dipstik)
Oedema
Nephrotic syndrome features
Frothy urine
Generalised oedema
Pallor
Deranged lipid profile
High BP
Hyper coagulability
Deranged lipid profile in nephrotic syndomre
High cholesterol + TGs + LDLs
What is there a tendency fro in nephrotic syndrome
Clots due to hypercoagualability
Most common cause of nephrotic syndrome in children
Minimal change disease - 90% of cases in children under 10
Secondary causes of nephrotic syndrome due to intrinsic kidney disease
Focal segmental glomeruloslerosis
Mebranoproliferative glomerulonephritis
Seconadry causes of nephrotic syndrome - sysyemic
HSP
Diabetes
Infection eg HIV, hepatitis, malaria
What does urinalysis show in minimal change disease?
Small molecular weight proteins and hyaline casts
What would renal biopsy and standard microscopy detect in minimal change disease?
Nothing - no abnormalities
How manage minmal change disease?
Corticosteroids eg prednisolone
Management of nephrotic syndrome
High dose steroids
Low salt diet
Diuretics - oedema
Albumin transfusions - severe hypoalbuminaemia
Antibiotics prophylaxis - severe cases
Course of streoids for NS
4 weeks high dose
Weaned off for next 8 weeks
% children sensitive to steroids and course
80% - 80% of these will relapse and require more
