Nephrotic syndrome

Causes

Appropriate Tests

 

Usually defined as urinary protein > 3g per day, with Hypoalbuminaemia, generalised oedema and, usually, Hyperlipidaemia.

Random Protein urine and Creatinine urine (protein/creatinine ratio) is generally sufficient to establish the diagnosis, although 24 hour collections are traditionally used.

Albumin, Protein, Cholesterol, Triglycerides; Urea, Creatinine, Electrolytes, eGFR.

Other useful tests include MCS urine (cell count, red cell morphology), Full blood count, and Blood film.

Renal loss of immunoglobulins and complement components may predispose to infection.

Primary glomerular disease

Renal biopsy with electron microscopy and immunofluorescence on fresh tissue.

Glomerulonephritis, especially

  • Minimal change disease (children)
  • Primary membranes GN

Phospholipase A2 receptor antibodies

Hereditary nephropathies

  • Alport syndrome

Genetic analysis

Glomerulopathy associated with other diseases

 

Diabetes mellitus

 

SLE

 

Drug reactions

  • NSAID
  • Gold
  • Captopril

 

Infections

  • Hepatitis B virus infection
  • Malaria

 

Neoplasia

  • Lymphoma (non-Hodgkin)
  • Carcinoma
  • Plasma cell myeloma

 

Amyloidosis