Nephrotic Syndrome Flashcards
(20 cards)
What is nephrotic syndrome?
A constellation of clinical and laboratory features of renal disease characterized by increased glomerular permeability, leading to protein loss into the tubules.
What are the triad features of nephrotic syndrome?
Massive proteinuria (>3.5 g/24 hours), hypoalbuminemia (<25 g/L), and edema.
What is the hallmark feature of nephrotic syndrome?
Loss of large amounts of protein in the urine (>3500 mg/24 hours).
How does hypoalbuminemia lead to hyperlipidemia in nephrotic syndrome?
Decreased oncotic pressure stimulates the liver to produce lipoproteins, causing high cholesterol levels.
What are common complications of nephrotic syndrome?
Increased susceptibility to infection, thromboembolism, and hyperlipidemia.
What are the primary causes of nephrotic syndrome?
Minimal change disease, focal segmental glomerulosclerosis (FSGS), and membranous glomerulonephritis.
What are secondary causes of nephrotic syndrome?
Diabetic nephropathy, systemic lupus erythematosus (SLE), infections (HIV, hepatitis B), and amyloidosis.
What is the most common cause of nephrotic syndrome in children?
Minimal change disease (80-90% of cases).
What is the initial management for nephrotic syndrome?
Dietary salt and water restriction, normal protein intake, and diuretics (e.g., furosemide).
What side effect is commonly associated with ACE inhibitors?
Dry cough (10-15% of patients) and hyperkalemia.
How is minimal change disease diagnosed?
Renal biopsy showing normal glomeruli on light microscopy and fusion of podocyte foot processes on electron microscopy.
What is the recommended treatment for minimal change disease?
High-dose corticosteroid therapy (e.g., prednisolone).
Which medications are second-line treatments for steroid-refractory minimal change disease?
Cyclophosphamide, ciclosporin, and rituximab.
What is the defining histological feature of focal segmental glomerulosclerosis (FSGS)?
Segmental glomerulosclerosis seen on light microscopy.
How is membranous glomerulopathy primarily managed?
Observation for spontaneous remission; cyclophosphamide and corticosteroids for severe cases.
What is a key diagnostic feature of membranous glomerulopathy?
Presence of IgG4-type autoantibodies against phospholipase A2 receptor (PLA2R).
Why is a renal biopsy performed in adults with nephrotic syndrome?
To distinguish between primary and secondary causes and confirm diagnosis.
What are oval fat bodies in urine microscopy indicative of?
Macrophages engorged with lipids, commonly seen in nephrotic syndrome.
Why is furosemide used cautiously in nephrotic syndrome?
It increases potassium excretion, risking hypokalemia.
What is the recommended protein intake for patients with nephrotic syndrome?
Normal protein intake (1 g/kg per day).
