Nephrotic syndrome - Lecture notes 44 PDF

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Summary

pathophysiology, signs and symptoms, investigations and management...

Description

Nephrotic syndrome Pathophysiology - Excess protein in urine which leads to hypoproteinaemia and hypoalbuminemia - Damaged basement membrane on glomerulus leads to increased permeability to the Bowmans capsule so protein leaks

Triad -

Low serum albumin High urine output Oedema

Causes - Primary or secondary glomerular disease - Primary  minimal change disease - Secondary  o diabetic kidney disease o NSAIDS o Hep B+C o Pregnancy

Signs and symptoms - Kids  oedema in face - Adults  peripheral oedema, pleural effusion and fluid overload - Frothiness in urine - Tiredness - Hypercoagubility which can be presented as DVT - hypoalbuminemia - Proteinuria - Pallor

Investigations - Ultrasound with biopsy  gold standard - New oedema  always dipstick - Dipstick  proteinuria and haematuria - MSU  culture and sensitivity - Bloods  FBC,U+E, Creatinine, coagulation screen, LFT, red cell casts

Management

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Adults  o sodium and fluid retention o diuretics o Children  o Corticosteroids o Decrease salt intake...