Nephrotic Syndrome

Question 1

What is Nephrotic Syndrome

Answer 1

Triad of

• persistent proteinuria (>3.5g/day)
• hypoalbuminaemia (<30g/l)
• oedema (decreased oncotic pressure/water retention)

Question 2

What is the pattern of oedema in Nephrotic Syndrome?

Answer 2

Periorbitally

Peripherally (limbs)

Question 3

What are the two main complications of Nephrotic Syndrome?

Answer 3

Hyperlipidaemia
Venous thrombosis
-renal loss of thrombo/lipo regulatory proteins

Question 4

What are the most common primary causes of Nephrotic Syndrome?

Answer 4

DM
Minimal change neuropathy
Membranous glomerulonephritis
Focal segmental glomerulosclerosis

Question 5

What are the common secondary causes of Nephrotic Syndrome?

Answer 5

Bacterial/viral infection
Drugs
Neoplasm

Question 6

How should Nephrotic Syndrome be investigated?

Answer 6

Bloods (FBC, U&Es, CRP, culture)
Urine dip (?infec)
MCS (red cells/Bence-Jones protein)
Urine protein:creatinine ratio
Nephritic screen
Renal USS + biopsy

Question 7

What are the management options for Nephrotic Syndrome?

Answer 7

Diuretics
Salt/water restriction
ACEIs
Anticoagulation (if immobile)
Treat underlying cause

Question 8

What is Nephritic Syndrome?

Answer 8

Tetrad of:

• haematuria plus red cell casts
• oliguria
• proteinuria
• HTN

Question 9

What are the key differences between Nephrotic & Nephritic Syndrome pathophysiologically?

Answer 9

Nephrotic - non proliferative

Nephritic - proliferative, increased cell numbers/damage

Question 10

What are the common primary causes of Nephritic Syndrome?

Answer 10

IgA nephropathy
Goodpastures
Proliferative glomerulonephritis

Question 11

What are the common secondary causes of Nephritic Syndrome?

Answer 11

SLE

HSP

Question 12

Describe minimal change nephropathy?

Answer 12

V. common in children

Treat w/ steroids, biopsy if no improvement >1mo