Nephrotic Syndrome (NS)

Diagnostic lab tests

Physical

Color: Yellow
Clarity: hazy (possibly cloudy)

Chemical

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

Microscopic

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

Main topic

Most common symptoms/relevant clinical history

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

Hypoproteinemia

Hyperlipidemia

Lipiduria

Edema (pitting)

Foamy urine

Weight gain, fatigue

Renal disease classification

Glomerular disease

Pathologic

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

AG and NS differences

See Proteins: Module 3, Slide 14

Possible causes

Diabetes mellitus

Kidney disease

Glomerulosclerosis

Systemic lupus erythmatosus

Lab findings

BUN increased

Creatinine increased

Hematuria

Oliguria

Conditions that may lead to NS

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

Systemic disease can also lead to NS

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