Nephrotic syndrome Flashcards
Define nephrotic syndrome
Consists of a triad of:
- Proteinuria (>3.5g/day)
- Hypoalbuminaemia
- Peripheral oedema
What are primary causes of nephrotic syndrome?
Due to direct damage to podocytes
- Minimal change disease
- Focal segmental glomerulosclerosis
- Membranous nephropathy
What are secondary causes for nephrotic syndrome?
Secondary to a systemic disease
- Diabetic nephropathy
- Amyloidosis
What is the most common cause for nephrotic syndrome in children?
Minimal change disease (90%)
What is the most common cause for nephrotic syndrome in adults?
- Diabetic nephropathy
2. Membranous nephropathy
Which cause of nephrotic syndrome responds to steroid treatment?
Minimal change disease
What are the presenting symptoms of nephrotic syndrome?
- Swelling of area around eyes and limbs
2. symptoms of underlying cause
What are the signs of nephrotic syndrome on physical examination?
- Periorbital oedema
- Peripheral oedema
- Ascites - shifting dullness
Are patients with nephrotic syndrome in a hyper or hypocoagulable state? and why?
Hypercoagulable
Because they lose antithrombin III protein in their urine (proteinuria) and so their blood is more likely to coagulate.
Are patients with nephrotic syndrome at a higher or lower risk of infection and why?
Higher risk of infection.
This is because they are losing immunoglobulins in urine
Do patients with nephrotic syndrome have hyper or hypolipidaemia? And why?
Hyperlipidaemia
Because of the loss of lipids in the urine, the liver increases lipoprotein synthesis and so lipid levels in the blood increase.
What are the appropriate investigations for nephrotic syndrome?
- Bloods - LFTs (low albumin), glucose and lipid profile
- Antibodies for SLE (ANA and anti-dsDNA)
- Urinalysis - high protein and lipids
- Renal biopsy
