nephrotic syndrome Flashcards
what are features of nephrotic syndrome?
proteinuria- PCR>300mg/mm or >3g/24h
hypoalbuminaemia <35g/L
oedema- periorbital, genital, ascites, peripheral- often intravascularly depleted w no JVP visible
what are complications of nephrotic syndrome?
infection- reduced Ig, reduced complement activity
vte- up to 40%
hyperlipidaemia- high cholesterol + TG
what investigations are needed for nephrotic syndrome?
lipids
biopsy- all adults
steroids first with children- mostly minimal change
in what diseases can nephrotic syndrome occur secondary to systemic disease?
diabetes- glomerulosclerosis
SLE- membranous
amyloidosis
what are types of conditions that are nephrotic syndrome?
minimal change glomerulonephritis
membranous nephropathy
FSGS
membranoproliferative/mesangiocapillary GN
which is the most common type of nephrotic syndrome?
minimal change GN
what are diseases associated with membranous nephropathy?
cancer- lung, colon, breast
autoimmune- SLE, thyroid
infections- HBV
drugs- penicillamine, gold
what are biopsy results of membranous nephropathy?
subepithelial immune complex deposits
what is the treatment of membranous nephropathy?
immunosuppression if renal function declines
what is the prognosis of membranous nephropathy?
40% spontaneous remission
what group of people is FSGS most common in?
afro-carribeans
what is the cause of FSGS?
idiopathic
or secondary to:
- VUR
- berger’s/iga nephropathy
- SCD
- HIV
what are the biopsy results of FSGS?
focal scarring
IgM deposition
what is the treatment of FSGS?
steroids or cyclophosphamide/ciclosporin
what is the prognosis of FSGS?
30-50% ESRF
may recur in transplants
