Nephrotic Syndrome

Question 1

Types of Nephrotic syndrome

Answer 1

Steroid sensitive and steroid resistant

Question 2

What type of nephrotic syndrome is more common?

Answer 2

steroid sensitive and this type is precipitated by a resp tract infection

Question 3

What is the cause?

Answer 3

Unknown but associated with vasculitidies HSP and SLE

Question 4

What are the classic signs of nephrotic syndrome?

Answer 4

periorbital edema, proteinuria, peripheral edema, no haematuria, breathlessness due to pleural effusion, srotal vulval and ankle edema, infections due to the excretion of immunoglobulins

Question 5

How is it diagnosed?

Answer 5

3 + protein on dipstick

Question 6

Treatment of steroid sensitive

Answer 6

oral steroids 60mg/m2 oral pred, reduce to 40mg after 4 weeks altering days for 4 weeks, Do renal biopsy in no response
Treat hypovolemia with fluids like albumin or .9% saline
if severe give 20% albumin and furosemide

Question 7

Treatment of steroid resistance

Answer 7

diuretics, salt restriction, ACEi, CoQ10 (if defect)

Question 8

Causes of proteinuria

Answer 8

orthostatic(most common)
Glomerular: Minimal change disease, glomerulonephritis,familial nephritides
Inc. GF pressure
Reduced renal mass in CKD
Htn
Tubular proteinuria

Question 9

Complications

Answer 9

hypovolemia and infections, hypercholesterolemia,thrombosis due to loss of antithrombin 3,