2. DEFINITION
The term Nephrotic syndrome describes a
clinical course that can be associated with a
number of disease conditions. Nephrotic
syndrome is not a single diseases entirely
but a constellation of symptoms including
albuminuria, hypoalbuminuria, edema,
hyperlipidemia, and lipduria. This
syndrome causes damage to the glomeruli
with resultant Proteinuria.
8. 4) Circulatory problems
Severe congestive heart failure
Chronic constructive Pericarditis
5) Allergic reaction
Insect bites, bee sting and pollen
Drugs (penicillamine, non steroidal
anti inflammatory drugs)
9. Clinical manifestation
It is characterized by Proteinuria
(>3.5g/day), hypoalbuminuria,
hyperlipidemia and edema which is
generalized & also known as anasarca
or dropsy. The edema begins in the
face. Lipduria (lipids in urine) can also
occur, but is not essential for the
diagnosis of Nephrotic syndrome.
16. CONTD…
Monitoring kidney function:
Do EUCs daily and calculating GFR.
Treat hyperlipidemia to prevent further
atherosclerosis.
Prophylactic anticoagulation may be
appropriate in some circumstances.
17. CONTD…
Specific treatment of underlying cause
Immunosuppressant for the
glomerulonephritides (corticosteroids,
cyclosporine).
Standard regime for first episode:
prednisolone-60 mg/m2/day in 3 divided
doses for 4 weeks followed by
40 mg/m2/day in a single dose on every
alternate day for 4 weeks.
18. CONTD…
Relapses by prednisolone 2 mg/kg/day till
urine becomes negative for protein. Then,
1.5 mg/kg/day for 4 weeks.
Frequent relapses treated by:
cyclophosphamide or nitrogen mustard or
cyclosporine or levamisole.
Achieving better blood glucose level control
if the patient is diabetic.