Nephrotic syndrome

Question 1

Nephrotic syndrome?

Answer 1

Triad of proteinuria (>3g/24hr),

hypoalbuminaemia (<30g/L),

oedema.

Hypercholesterolaemia is also common.

Question 2

Nephrotic syndrome aetiology?

Answer 2

most commonly caused by minimal change glomerulonephritis in children.

Other causes are DM, sickle cell disease, amyloidosis, malignancies, drugs (NSIADs), HIV.

Question 3

Nephrotic syndrome epidemiology?

Answer 3

90% in children due to minimal change glomerulonephritis, most common cause in adults is DM and membranous glomerulonephritis.

Question 4

Nephrotic syndrome symptoms?

Answer 4

family history of atopy and renal disease,

swelling of face,

abdo,

limbs,

genitalia.

Question 5

Nephrotic syndrome signs?

Answer 5

Oedema: periorbital, peripheral, genital.

Ascites: fluid thrill, shifting dullness.

Question 6

Nephrotic syndrome investigations?

Answer 6

FBC, U&Es, LFTs (low albumin), ESR/CRP, glucose, l

ipid profile (to check for secondary hyperlipidaemia),

urinalysis to check for protein and blood,

renal USS to eclude other causes.

Question 7

Nephrotic syndrome test for underlying cause?

Answer 7

SLE - ANA,

HBV infection (serology),

Plasmodium malariae (blood film),

Goodpasture’s Syndrome – anti-glomerular basement antibodies,

Vasculitides - polyangiitis with granulomatosis, microscopic polyarteritis (check ANCA)