Nephrotic syndrome Flashcards
What is nephrotic syndrome
condition characterised by loss of protein in urine due to increased glomerular permeability –
leads to low serum albumin levels and oedema
What primary glomerular diseases usually cause nephrotic syndrome
minimal change disease
focal segmental glomerulosclerosis
membranous nephropathy
What is minimal change disease
nearly always presents as nephrotic syndrome
accounts for 75% in chilidren
Causes of minimal change disease?
idiopathic
sometimes-
drugs-NSAIDs, rifampicin
Hodgkin’s lymphoma
infectious mononucleosis
Pathophysiology of minimal change disease?
T cell and cytokine mediated damage to glomerular basement membrane- polyanion loss
resultant reduction of electrostatic charge –increased permeability to serum albumin
What is focal segmental glomerulosclerosis
scarring/ hardening of some parts of the glomeruli
What is membranous nephropathy
chronic immunologically mediated disease of the glomerular basement membrane that may resolve spontaneously
common cause of nephrotic syndrome in adults
What are some secondary causes of nephrotic syndrome
systemic diseased like
DM, Lupus and amyloidosis
What are some complications of nephrotic syndrome
infection, thrombosis, malnutrition
What does no haematuria indicate
makes nephrotic syndrome more likely over nephritic syndrome
What is the usual triad of things seen in a patient with nephrotic syndrome
Proteinuria, hypoalbuminemia and peripheral oedema
How may a patient with nephrotic syndrome present
oedema- around eyes, legs and feet
fatigue , decreased urine output, anorexia
What is the first line of investigation for nephrotic syndrome
urine dipstick test – will show increased levels of proteinuria
What can confirm the diagnosis of nephrotic syndrome
24 hr urine collection
proteine excretion >3.5g/day
What will blood tests show
hypoalbuminemia,
hyperlipidaemia
elevated serum creatinine level
