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Flashcards in Nephrotic syndrome Deck (18)
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1
Q

What are the 3 main features of a Nephrotic syndrome?

A

Proteinuria - >3g/24hr

Hypoalbuminaemia -

2
Q

What are some of the complications of Nephrotic syndrome?

A

Decrease in Ig and complement causes an increased risk of infection
VTE in 40%
Hyperlipidaemia ( high cholesterol and high TAGs)

3
Q

What investigations can be done in a patient with suspected Nephrotic syndrome?

A

Check lipid levels
Biopsy
Protein Creatinine Ratio

4
Q

What are some of the diseases which can cause secondary Nephrotic syndrome?

A

DM - Glomerulosclerosis
SLE - Membranous
Amyloidosis

5
Q

What is Minimal change glomerulonephritis?

A

Most common cause of nephrotic syndrome in children
Idiopathic
Association with URTIs

6
Q

What is seen on biopsy in a patient with Minimal change glomerulonephritis?

A

Normal unless electron microscopy where fusion of podocytes is seen

7
Q

What is the treatment for Minimal change glomerulonephritis?

A

Steroids

Good prognosis, very rarely develops into renal failure

8
Q

What is Membranous nephropathy?

A

Deposition of immune complexes in the glomerular basement membrane causing damage and thickening
Nephrotic syndrome

9
Q

What is Membranous nephropathy associated with?

A

Cancer - Lung, Bowel, Breast
Autoimmune - SLE, Thyroid disease
Infections - HBV
Drugs - Penicillamine, Gold

10
Q

What is seen on biopsy in patients with Membranous nephropathy?

A

Subepithelial immune complexs deposited

11
Q

What is the treatment for Membranous nephropathy?

A

Immunosuppression if renal function declines

12
Q

What is Focal Segmental GlomeruloSclerosis? (FSGS)

A

Scarring of the glomerulus causing nephrotic syndrome and a decline in renal function
More common in afro-caribeans
Can be idiotpathic or secondary

13
Q

What are some of the causes of secondary FSGS?

A

HIV
IgA nephropathy
SLE
Vasculitis

14
Q

What is seen on biopsy in FSGS?

A

Focal scarring

IgM deposition

15
Q

What is the management of FSGS?

A

Steroids
Cyclophosphamide/Ciclosporin
Many develop renal failure, recurrence post transplant

16
Q

What is Membranoproliferative / Mesangiocapillary GN?

A

GBM thickening
Immune complex deposited in mesangium
Complement activated causing glomerular damage
May progress to nephrotic or nephritic syndrome
Associated with HBV, HCV and endocarditis
50% develop renal failure

17
Q

What is the management of Membranoproliferative / Mesangiocapillary GN?

A

Monitor U+Es, BP, Wt, Fluid balance

18
Q

How can you manage the complications of Nephrotic syndrome?

A

Proteinuria - ACEi/Angiotensin II receptor antagonists
Oedema - Salt/fluid restriction, frusemide
Increased lipids - Statins
VTE - Tinzaparin