Nephrotic Syndrome Flashcards
5 Characteristics of Nephrotic Syndrome
Proteinuria (>3.5g/day)
Hypoalbuminemia (
General causes of nephrotic syndrome
Podocyte slit diaphragm protein mutations
Podocyte injury
Other blood components lost in nephrotic syndrome
Antibodies
Clotting factors
Vitamin D
Primary Systemic Nephrotic Diseases (4)
Diabetes
Amyloid
SLE
Light Chain Disease
Primary Renal Nephrotic Diseases (5)
Hereditary Minimal Change Disease Focal Glomerularsclerosis Membranous Nephropathy Membranoproliferative Nephropathy
3 Most Common Hereditary Mutations
Nephrin, Podocin, and Wnt-1
Hereditary Nephrotic Syndrome
Steroid Resistant
Focal Segmental Glomerulosclerosis
Reduce Proteinuria w/ ACEIs, renal transplant
Minimal Change Disease
Most common nephrotic Children > Adults Glomeruli appear normal No AB or complement fixing, only podocyte fusion Post-viral association Circulating factor damages podocytes Normal GFR, no HTN Responds to steroids but can relapse
Focal Segmental Glomerulosclerosis
Young adults, AAs HIV (+APO-1) and Heroin association IF negative EM foot process fusion Steroid resistant Circulating Factor Treat w/ ACEI and Corticosteroids Relapses common ESRF common
Membranous Nephropathy
Subepithelial IC Deposits (AB to podocyte, complement-mediated injury)
Older Adults
Light: Thick GBM
IF: granular deposits, C3
Treat w/ steroids and cytotoxic
50% ESRD, 25% remission
Assoc w/ other diseases: malignancy, SLE, infection
Membranoproliferative Glomerulonephritis
GBM thickening w/ mesangial proliferation
Type 1 = subendo IgG IC deposits, C3
Type 2 = C3 w/o deposit
HCV association! Also infection, CTD, neoplasm
Amyloid
Pink fluffy material in glomeruli and vessels
Positive Congo Red w/ apple green birefringence
Diabetes
Hyaline arteriolar disease +/- HTN
Diffuse mesangium expansion and GBM thickening
