{"id":3468,"date":"2019-11-28T13:00:45","date_gmt":"2019-11-28T13:00:45","guid":{"rendered":"http:\/\/edren.org\/ren\/education\/textbook\/nephrotic-syndrome\/"},"modified":"2020-08-12T11:36:13","modified_gmt":"2020-08-12T11:36:13","slug":"nephrotic-syndrome","status":"publish","type":"page","link":"https:\/\/edren.org\/ren\/education\/textbook\/conditions-that-affect-the-kidney\/nephrotic-syndrome\/","title":{"rendered":"Nephrotic syndrome"},"content":{"rendered":"

\"\"<\/a>Nephrotic legs (normal for elephants), normal gazelle legs (Beth Shortt) illustrating oedema<\/a><\/span><\/p>\n

Usually defined as proteinuria >3.5g\/day with hypoalbuminaemia and oedema. Definitions vary a little around exact values. Serum albumin levels are low because of the urinary protein loss. Nephrotic syndrome is associated with avid sodium and fluid retention by the kidneys, seen symptomatically as oedema, in other words most retained fluid is held extravascularly.]\n

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Causes<\/span><\/strong><\/h3>\n

These are all glomerular diseases, in which there is podocyte (glomerular epithelial cell) damage or non-inflammatory architectural alterations of the glomerulus, such as that caused by matrix expansion associated with diabetes, or by scarring.\u00a0 Subacute inflammatory (nephritic) types of glomerulonephritis may cause nephrotic syndrome through causing scarring in the glomerulus.<\/p>\n

Most important causes of nephrotic syndrome:<\/p>\n\n\n\n\n\n\n\n\n
Minimal change disease<\/a><\/td>\nNormal glomeruli on light microscopy. The most common cause in children but occurs at any age. Responds to treatment with high dose steroids. Does not cause renal failure.<\/td>\n<\/tr>\n
Focal segmental glomerular sclerosis (FSGS)<\/a><\/td>\nFocal scars in glomeruli. Variable response to steroids. May progress to renal failure.<\/td>\n<\/tr>\n
Membranous nephropathy<\/a><\/td>\nUsually idiopathic (autoimmune); sometimes due to drugs, rarely malignancy. May progress to renal failure in up to 30%; immunosuppression may halt progression if function deteriorating.<\/td>\n<\/tr>\n
Diabetes mellitus<\/a><\/td>\nAfter long history of diabetes and with other microvascular complications.<\/td>\n<\/tr>\n
Amyloidosis<\/a><\/td>\nMost types cause renal disease (usually nephrotic syndrome) as an early manifestation.<\/td>\n<\/tr>\n
Systemic lupus erythematosus (SLE)<\/a><\/td>\nYoung women usually. May present in many ways but sometimes as renal disease alone.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
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Complications<\/span><\/strong><\/h3>\n