Nephrotic syndrome

Nephrotic syndrome (NS) results from loss of plasma proteins in the urine and characterised and characterised by hypoalbuminemia, hyperalbuminuria, hyperlipidemia, and oedema

It. It may be caused by primary (idiopathic) renal disease or by a variety of secondary causes.

Clinical presentation

Patients present with marked oedema, proteinuria, hypoalbuminemia, and often hyperlipidemia.

Pathology

It may be classified as congenital or acquired.

Congenital nephrotic syndrome types include ¹:

• congenital¹
  • nephrotic syndrome of Finnish type
  • focal and segmental hyalinosis (FSH)
  • minimal-change glomerular disease (MCGD)
  • neonatal glomerulonephritis
  • diffuse mesangial sclerosis

  In adults,

• acquired
  • primary: focal segmental glomerulosclerosis; membranous nephropathy
  • secondary: diabetes mellitus is the most common secondary cause, and focal segmental glomerulosclerosis and membranous nephropathy are the most common primary causes. When
  • when no cause is identified the term adult idiopathic nephrotic syndrome. is used

Associations

• systemic lupus eryhematosus  ^{reference required}

Complications

• venous thromboembolism²
• acute renal failure
• superimposed bacterial infection

Treatment and prognosis

Treatment of most patients should include fluid and sodium restriction, oral or intravenous diuretics, and angiotensin-converting enzyme inhibitors. Some adults with nephrotic syndrome may benefit from corticosteroid treatment, cyclosporin A, although research data are limited. Intravenous albumin, prophylactic antibiotics, and prophylactic anticoagulation are not currently recommended.