Pediatric hematuria and proteinuria Flashcards
laboratory findings in nephrotic syndrome
- reduced plasma protein
- increased cholesterol, TGs, lipoproteins
- decreased serum sodium
- decreased total calcium
- positive urine dipstick protein
what are the three histologic types of primary nephrotic syndrome?
- MCNS
- FSGS
- membranous nephropathy
what is the most common cause of nephrotic syndrome in children?
minimal change
LM and EM for MCNS
- LM: normal
- EM: effacement of epithelial foot processes
heroin use
sickle cell
diabetes
what subtype of nephrotic syndrome?
FSGS
membranous nephropathy is characterized by diffuse irregular thickening of the ____________
capillary walls
subepithelial spike and dome pattern - what subtype of NS?
membranous
what are the lab findings in membranoproliferative GS?
- hypocomplementemia
- UA: proteinuria, possible hematuria
- IF: Ig deposits on BM
- EM: BM thickening with double layer tram tracks
what are the secondary causes of nephrotic syndrome?**
- infections
- drugs
- malignancies
- other
what are the indications for renal biopsy?
at time of diagnosis:
- age over 10
- persistent or gross hematuria
- HTN
- renal insufficiency
- low C3
subsequently
- persistent proteinuria
what is the overall treatment for nephrotic syndrome?
- loop or thiazide
- ACEI / ARB
- statins
- pneumococcal vaccine
- vitamin D and calcium supplementation
- low sodium diet
what are the lab findings for nephritic syndrome?
- increased BUN
- increased Cr
- UA: hematuria and proteinuria
glomerular origin of hematuria?
- dysmorphic RBCs
- RBC casts
what are latency periods in pharyngitis and skin infections for PSGN?
- pharyngitis: 1-2 weeks
- skin: 3-6 weeks
what are the lab findings in PSGN? what is the EM finding?
- positive throat culture group A strep
- elevated strep Ab titers (ASO)
- decreased C3**
- RBC casts
- EM: bumpy deposits
