Nephrotic syndrome results from loss of plasma proteins in the urine and characterised by hypoalbuminemia, hyperalbuminuria, hyperlipidemia, and oedema. It may be caused by primary (idiopathic) renal disease or by a variety of secondary causes.
Patients present with marked oedema, proteinuria, hypoalbuminemia, and often hyperlipidemia 1.
- venous thromboembolism 1,2
- acute renal failure 1
- superimposed bacterial infection 1
It may be classified as congenital or acquired 1:
- when no cause is identified the term adult idiopathic nephrotic syndrome is used
Treatment and prognosis
Treatment of most patients should include fluid and sodium restriction, oral or intravenous diuretics, and angiotensin-converting enzyme inhibitors 1,4-6. Some adults with nephrotic syndrome may benefit from corticosteroid treatment, cyclosporin A, although research data are limited 1,4-6. Intravenous albumin, prophylactic antibiotics, and prophylactic anticoagulation are not currently recommended 1,4-6.
- 1. Hull RP, Goldsmith DJ. Nephrotic syndrome in adults. BMJ (Clinical research ed.). 336 (7654): 1185-9. doi:10.1136/bmj.39576.709711.80 - Pubmed
- 2. Gatewood OM, Fishman EK, Burrow CR et-al. Renal vein thrombosis in patients with nephrotic syndrome: CT diagnosis. Radiology. 1986;159 (1): 117-22. Radiology (citation) - Pubmed citation
- 3. Salame H, Damry N, Vandenhoudt K et-al. The contribution of ultrasound for the differential diagnosis of congenital and infantile nephrotic syndrome. Eur Radiol. 2003;13 (12): 2674-9. doi:10.1007/s00330-003-1920-x - Pubmed citation
- 4. Kodner C. Nephrotic syndrome in adults: diagnosis and management. Am Fam Physician. 2009;80 (10): 1129-34. Am Fam Physician (link) - Pubmed citation
- 5. Alaniz C, Brosius FC, Palmieri J. Pharmacologic management of adult idiopathic nephrotic syndrome. Clin Pharm. 1993;12 (6): 429-39. - Pubmed citation
- 6. Ponticelli C. Treatment of the nephrotic syndrome with cyclosporin A. J. Autoimmun. 1992;5 Suppl A : 315-24. - Pubmed citation
- 7. Wei LQ, Rong ZK, Gui L, Shan RD. CT diagnosis of renal vein thrombosis in nephrotic syndrome. Journal of computer assisted tomography. 15 (3): 454-7. Pubmed