Nephrotic syndrome Flashcards
What is nephrotic syndrome?
A disorder where the basement membrane of the glomerulus becomes permeable to proteins, resulting in protein in the urine
What age is nephrotic syndrome most common?
2 to 5 years
What is the classic triad of nephrotic syndrome?
High urinary protein (>+3 on a dipstick)
Oedema
Low serum albumin
What other features occur in nephrotic syndrome?
Frothy urine
Pallor
Deranged lipid profile
High blood pressure
Hyper-coagulability
What is the most common cause of nephrotic syndrome in children?
Minimal change disease
What are the causes of nephrotic syndrome secondary to kidney disease?
Focal segmental glomerulosclerosis
Membranoproliferative glomerulonephritis
What are the causes of nephrotic syndrome secondary to systemic illness?
Henoch-Schonlein purpura
Diabetes
Infection
What is minimal change disease?
Where nephrotic syndrome occurs in isolation
What are the investigation findings in minimal change disease?
A kidney biopsy and microscopy will show no change
Urinalysis will show small molecular weight proteins and hyaline casts
What is the treatment of minimal change disease?
Oral steroids - prednisolone
What is the general management of nephrotic syndrome?
High dose steroids
Low salt diet
Diuretics for oedema
Albumin infusions for severe hypoalbuminaemia
What drugs can be given to children who are steroid resistant?
ACE inhibitors
Immunosuppressants
What are the complications of nephrotic syndrome?
Hypovolaemia
Thrombosis
Infection
Acute or chronic renal failure
Relapse
