Nephrotic syndrome Flashcards
What are the 3 main features of a Nephrotic syndrome?
Proteinuria - >3g/24hr
Hypoalbuminaemia -
What are some of the complications of Nephrotic syndrome?
Decrease in Ig and complement causes an increased risk of infection
VTE in 40%
Hyperlipidaemia ( high cholesterol and high TAGs)
What investigations can be done in a patient with suspected Nephrotic syndrome?
Check lipid levels
Biopsy
Protein Creatinine Ratio
What are some of the diseases which can cause secondary Nephrotic syndrome?
DM - Glomerulosclerosis
SLE - Membranous
Amyloidosis
What is Minimal change glomerulonephritis?
Most common cause of nephrotic syndrome in children
Idiopathic
Association with URTIs
What is seen on biopsy in a patient with Minimal change glomerulonephritis?
Normal unless electron microscopy where fusion of podocytes is seen
What is the treatment for Minimal change glomerulonephritis?
Steroids
Good prognosis, very rarely develops into renal failure
What is Membranous nephropathy?
Deposition of immune complexes in the glomerular basement membrane causing damage and thickening
Nephrotic syndrome
What is Membranous nephropathy associated with?
Cancer - Lung, Bowel, Breast
Autoimmune - SLE, Thyroid disease
Infections - HBV
Drugs - Penicillamine, Gold
What is seen on biopsy in patients with Membranous nephropathy?
Subepithelial immune complexs deposited
What is the treatment for Membranous nephropathy?
Immunosuppression if renal function declines
What is Focal Segmental GlomeruloSclerosis? (FSGS)
Scarring of the glomerulus causing nephrotic syndrome and a decline in renal function
More common in afro-caribeans
Can be idiotpathic or secondary
What are some of the causes of secondary FSGS?
HIV
IgA nephropathy
SLE
Vasculitis
What is seen on biopsy in FSGS?
Focal scarring
IgM deposition
What is the management of FSGS?
Steroids
Cyclophosphamide/Ciclosporin
Many develop renal failure, recurrence post transplant
