Nephrotic syndrome Flashcards
What is the definition of nephrotic syndrome?
proteinuria >3.5 g/day
What is the general cause of proteinuria?
increase BM permeability
In addition to proteinuria, what are some other lab findings in nephrotic syndrome?
hypoalbuminemia - edema
hypogammaglobulinemia - infection
hypercoaguability - loss of antithrombin III
hyperlipidemia and hypercholesterolemia (liver attempts to make blood thick)
What causes minimal change disease?
cytokines cause effacement of podocytes
What cancer can be associated with minimal change disease?
hodkins lymphoma
What is the treatment for minimal change disease?
steroids -disease is immunogenic
What is the most common cause of nephrotic syndrome in:
- asians
- blacks
- hispanics.
- caucasians
asians and caucasians - membranous nephropathy
blacks and hispanics - focal segmental sclerosis
What is seen pathologically in focal segmental sclerosis?
deposition of collagen in some parts of a few glomeruli
hyalinosis, effacement of foot processes
What is seen pathologically in membranous nephropathy?
subeithelial deposits with spike and dome
thickened glomerular basement membrane
What is believed to be the cause of primary membranous nephropathy?
anti-PLA2R antibodies on podocytes
Describe the subepithelial deposits in membranous nephropathy?
cations, low avidity - free
What are the pathological findings in membranoproliferative nephropathy?
mesangial deposits, GBM thickening
“tram track appearance”
In type I MPF Nephropathy, what specifically is seen?
subendothelial deposits, mesangial deposits
hypercellularity
Capillary wall thickening
What is type I MPF nephropathy associated with?
chronic infections
Which arm of the complement pathway is activated in MPF nephropathy? What happens as a result?
type 1 - classical
type 2 - alternate
hypocomplementemia
What is type II MPF nephropathy caused by?
anti- c3 nephritic factor
What is another name for Type II MPF nephropathy?
dense deposit disease
-ribbon like zone of inc density w/in thickened GBM
What is the only cause of nephrotic syndrome that can’t also be nephritic?
minimal change disease
What is the most common cause of nephrotic syndrome in children?
minimum change disease
How does diabetes cause nephrotic syndrome?
- nonenzymatic glycosylation of protein –>increase in mesangial matrix and sclerosis
- hyperfilitration leads to microalbuminuria and then eventually nephrotic syndrome
What is the pathognomonic finding of the kidney in diabetes?
kimmelstein wilson nodules
-Nodules of pink hyaline material form in regions of glomerular capillary loops in the glomerulus
Where does amyloid deposit in the kidney?
mesangium
