nephrotic syndrome Flashcards
what is nephrotic syndrome?
issue with filtration carrier ( mainly podocytes)
therefore protein leaks into urine
what are the primary causes of nephrotic syndrome?
- minimal change disease - mc in children
- focal segmental glomerulosclerosis- mc in adults
- membraneous nephropathy
what are the secondary causes of nephrotic syndrome?
- DANI-dialysis-associated neurovascular injury
- Diabetes
- drugs
- autoimmune
- neoplasia
- infection
what are the symptoms of nephrotic syndrome?
triad of:
- hypoalbuminaemia
- proteinuria ( frothy apple juice urine)
- oedema ( low oncotic pressure due to low albumin)
other symptoms of nephrotic syndrome?
- hyperlipidaemia
- weight gain
how is nephrotic syndrome diagnosed - minimal change disease ?
- light microscope- no change
- e microscope- podocyte effacement and fusion
how is nephrotic syndrome diagnosed - focal segmental glomerulosclerosis ?
- light microscope- segmental sclerosis
- less than 50% of glomeruli affected
how is nephrotic syndrome diagnosed - membraneous nephropathy ?
- light microscope- thickened GBM
- e microscope- subpodocyte immune complex deposition, spike and dome appearance
what are other tests done to diagnose nephrotic syndrome?
- renal biopsy
- urinalysis –> proteinuria
- bloods–> lipids and renal function
- urine protein: creatine ratio ( degree of proteinuria
how is nephrotic syndrome treated?
- steroids for 12 weeks
—– minimal change responds well
—–FSG + MW respond less well - loop diuretics
- fluid restriction
- ACE-i/ ARB
What are the complications associated with nephrotic syndrome?
- hyperlidiaemia- due to increased cholesterol to compensate for loss of albumin
- VTE- due to increased clotting factors
