Chapter 7

NEPHROTIC SYNDROME (NS)

Diagnosis is defined as:

• Excretion of more than 3.5 gm protein/24 hours/1.73 m2 BSA?
• Hypoalbuminemia
• Hypercholesterolemia
• Edema

Other findings:

• Urine: oval fat bodies (frequent); coarse granular casts (occasional)
• Diagnosis not ruled out by microscopic hematuria
• Imaging necessary for exact localization of biopsy site
• Imaging is non-contributory to diagnosis

Nephrotic syndrome is subdivided into primary or idiopathic, and secondary or systemic:

• Primary: nephrotic syndrome (edema and proteinuria) not accompanied by others symptoms. Diagnosis is by renal biopsy
• Systemic nephrotic syndrome: kidney disease plus signs and symptoms in other organs
• Kidney biopsy demonstrates that nephrotic syndrome results from glomerular basement membrane (GBM) pathology

Remember:

• Associate the "O" in nephrOtic syndrome with prOteinuria
• Expect renal biopsy to show pathology of the GBM