Nephrotic Syndrome

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Nephrotic Syndrome (NS)

Conditions that may lead to NS

Systemic disease can also lead to NS

Diabetes mellitus, SLE, amyloidosis, malignant neoplasms, infections, renal response to nephrotoxic agents (drugs, poisons)

Minimal change disease, membranous glomerulonephritis, focal segmented glomerulosclerosis, membranoproliferative glomerulonephritis (90% of cases in children; 75% of cases in adults

Lab findings

Oliguria

Hematuria

Creatinine increased

BUN increased

Possible causes

Systemic lupus erythmatosus

Glomerulosclerosis

Kidney disease

Diabetes mellitus

AG and NS differences

See Proteins: Module 3, Slide 14

Renal disease classification

Group of clinical features that occur simultaneously representing increased permeability of the glomeruli to the passage of plasma proteins (albumin)

Pathologic

Glomerular disease

Most common symptoms/relevant clinical history

Weight gain, fatigue

Foamy urine

Edema (pitting)

Lipiduria

Hyperlipidemia

Hypoproteinemia

Heavy/severe proteinuria (greater than or equal to 3 g/day)

Main topic

Diagnostic lab tests

Microscopic

RBC RTE OFB Free fat droplets Casts all types (particularly, fatty, waxy, RTE)

Chemical

Blood: Small Protein: Severe (>2000 mg/dL) (>3.5 g per 24hrs)

Physical

Color: Yellow Clarity: hazy (possibly cloudy)