Nephrotic Syndromes Flashcards
Five Hallmarks of Nephrotic Syndrome
- Hypoalbuminemia
- Edema
- Hypercoagulable state
- Hyperlipidemia
- Hypercholesterolemia
Proteinuria is > _____ /day
3.5 g
Hypercoagulable state is caused by loss of __________
ATIII
Most common cause of nephrotic disease in children
Minimal Change Disease
Associated with Hodgkin Lymphoma
Minimal Change Disease
Effacement of foot processes on E&M
Minimal Change Disease
FSGS
Selective proteinuria, but not loss of immunoglobulin
MCD (“Minimal” Loss)
Excellent response to steroids (damage is mediated by cytokines from T cells)
MCD
If not treated, MCD would progress to _______, which is one way to think about why these two diseases are both associated with effacement of foot processes
FSGS
Most common cause of nephrotic syndrome in AA and Hispanics
FSGS
Associated with HIV infection, heroin abuse, massive obesity, interferon treatment, sickle cell, and CKD due to congenital absence or surgical removal
FSGS
No immune complexes, negative IF
MCD and FSGS
Most common cause of nephrotic syndrome in Caucasian adults
Membranous Nephropathy
Associated with Hepatitis B/C, solid tmors, most common nephrotic presentation of SLE, or drugs (NSAIDs, pencillamine)
Membranous Nephropathy
Thick glomerular basement on H&E
Membranous Nephropathy
Due to immune complex deposition (granular IF), creating subepithelial deposits with “spike and dome” appearance (EM)
Membranous Nephropathy
Thick glomerular basement membrane on H&E, often with “tram-track” appearance due to GBM splitting by mesangial ingrowth
Membranoproliferative GN
Subendothelial deposits; associated with HBV and HCV
MPGN Type I
GBM deposits; associated with C3 nephritic factor (auto-antibody that stabilizes C3 convertase, leading to over-activation of complement, inflammation, and low levels of circulating C3)
MPGN Type II
Hyaline arteriosclerosis occurs secondary to _______ in DM nephropathy
NEG of vascular basement membrane
The glomerular __________ arteriole is preferentially affected by hyaline arteriosclerosis in DM nephropathy
efferent
Characterized by sclerosis of mesangium with formation of esoinophilic Kimmelstiel-Wilson nodules
DM Nephropathy
Characterized by apple-green birefringence under polarized light after staining with Congo red
Amyloidosis of kidney - deposits in mesangium
