Nephrotic syndrome results from loss of plasma proteins in the urine and characterized by hypoalbuminemia, hyperalbuminuria, hyperlipidemia, and edema. It may be caused by primary (idiopathic) renal disease or by a variety of secondary causes.
Patients present with marked edema, 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
Nephrotic syndrome per se may produce non-specific appearances due to marked edema and hypoalbuminemia, e.g. anasarca, bowel wall thickening, etc. Chyluria may be seen due to the heavy losses of chyle/fats in the urine.
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.
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- 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