Nephrotic syndrome

Question 1

Nephrotic syndrome is characterized by:

Answer 1

Heavy proteinuria (> 3.5g/day) Hypoalbuminemia Edema Hyperlipidemia and lipiduria (liver’s compensatory Mechanism due to hypoalbuminemia) Normal complement levels

Question 2

What are the 5 causes of nephrotic syndrome?

Answer 2

• Membranous nephropahty (immunoglobulin deposition) - minimal change - FSGS - diabetic nephropathy - amyloidosis

Question 3

What kind of patients do you see with minimal change disease?

Answer 3

Children; cannot biopsy their kidneys so will see: low albumin normal creatinine

Question 4

Do patients with minimal change disease respond to steroid treatment?

Answer 4

Yes

Question 5

While minimal change disease is idiopathic in kids, but what is the major cause of this in adults?

Answer 5

NSAIDS

Question 6

What is the most common malignancy that can cause minimal change disease in adults?

Answer 6

Hodgkin’s lymphoma (and renal cell carcinoma)

Question 7

How can doctors diagnose FSGS in pediatric patients?

Answer 7

Must biopsy. Patients with FSGS DO NOT respond to steroid treatment

Question 8

The primary target of minimal change disease is the ____________

Answer 8

Glomerular epithelial cells (podocyte) causing effacement and detachment

Question 9

What would you see in LM, IF and EM in a patient with minimal change disease

Answer 9

LM: normal IF: no immunoglobulin deposits EM: fusion of foot processes and effacement, and detachment