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Learning Nephrotic Syndrome: Series 2



Check out my previous blog on the series of learning nephrotic syndrome :




In this blog we will briefly learn about types, diagnosis, and treatment of nephrotic syndrome.


TYPES OF NEPHROTIC SYNDROME

Primary nephrotic syndrome can be of four types:


  • Minimal­-Change Disease: There is no visible damage seen in kidney biopsies. Seen commonly in children. 

  • Focal Glomerulosclerosis:  Scars on glomeruli are visible. These  scars can be due to genetic defects or external damage. 

  • Membranous Nephropathy: Defect in the body's immune system leads to protein build up in glomerular capillary, resulting in increased permeability to larger molecules such as proteins.


  • Hereditary Nephropathies: Occur due to genetic variations at birth or infections such as syphilis or toxoplasmosis in parents before birth. 


Secondary nephrotic syndrome may occur due to infections, diseases such as lupus, cancer or diabetes and medications that are harmful to kidneys  

 

DIAGNOSIS

  • First step is to identify risk factors such as previous infections, chronic illness or history of using medications that can cause kidney damage

  • Urine dipstick test to confirm proteinuria

  • Blood test to identify albumin and lipid levels

  • Kidney biopsies, ultrasound, or other tests to confirm diagnosis 



TREATMENT

Your doctor may prescribe medication to manage underlying conditions or symptoms. 

Medications may include: 

  • Blood pressure lowering medications, 

  • Albumin infusion, 

  • Steroids, 

  • Cholesterol lowering medications, or 

  • Antibiotics to treat infections. 



Managing nephrotic syndrome is essential even when patients are in remission meaning they are not experiencing any symptoms by making lifestyle changes such as:

  • Avoid fatty foods 

  • Follow healthy balanced diet

  • Limit sodium intake < 3g/day and fluid intake to <1.5L/day. 

  • Keeping up to date on vaccinations and doctor’s appointments

  • Keep checking for proteinuria daily using urine dipstick tests regularly. 



REFERENCES:


  1. Ramapriya Sinnakirouchenan, M. (2023, September 26). Nephrotic syndrome. Practice Essentials, Pathophysiology, Etiology. https://emedicine.medscape.com/article/244631-overview?form=fpf  

  2. Tapia C, Bashir K. Nephrotic Syndrome. [Updated 2023 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470444/

  3. Mayo Foundation for Medical Education and Research. (n.d.). Nephrotic syndrome. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/nephrotic-syndrome/symptoms-causes/syc-20375608   

  4. U.S. Department of Health and Human Services. (n.d.). Nephrotic syndrome in children - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/children/nephrotic-syndrome-children  

  5. U.S. Department of Health and Human Services. (n.d.-a). Nephrotic syndrome in adults - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/nephrotic-syndrome-adults  

  6. Kodner C. (2009). Nephrotic syndrome in adults: diagnosis and management. American family physician, 80(10), 1129–1134. 

  7. U.S. Department of Health and Human Services. (n.d.). Nephrotic syndrome in children - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/children/nephrotic-syndrome-children   

  8. Nephrotic Syndrome Management. Perth Childrens Hospital. (n.d.). https://pch.health.wa.gov.au/For-health-professionals/Clinical-Practice-Guidelines/Nephrotic-Syndrome-Management 

  9. Robert S. Gillespie, M. (n.d.). Management of nephrotic syndrome in children. HCP Live. https://www.hcplive.com/view/2005-08_01    Assessed and Endorsed by the MedReport Medical Review Board

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