Features of nephrotic syndrome
- Massive proteinuria
- Edema
- HypERlipidemia
- HyPOalbuminemia
Etiology or nephrotic syndrome
A (5)
B (3)
C _
A. Primary
1. Minimal change disease
2. Membranous nephropathy
3. FSGN
4. C3 glomerulopathy
5. Membranoproliferstive GN
B. Secondary
1. Infection
2. Malignancy
3. Systemic dse (SLE HSP etc)
C. hereditary
Nephrotic syndrome that is most common cause of esrd in adolescents
FSGN
Most common cause of childhood nephrotic syndrome
Minimal Change nephrotic syndrome
Differential diagnosis in children presenting edema
- Protein losing enteropathy
- Hepatic failure
- Heart failure
- AGN/CGN
- Protein malnutrition
- Allergy
Diagnostics/ evaluation to rule out secondary forms of nephrotic syndrome in children
- C3 level
- ANA
- DsDNA
- Hepa B and C, HIV in high risk population
- Renal biopsy if >13 y/o
attainment of remission within initial 4-wk steroid therapy
Steroid responder
Urine prot/crea ratio <0.2 or <1+ protein on dipstick testing for 3 consecutive days usually within 2-3wks treatment
In short absence of proteinuria
Remission
Urine prot/crea ration of >2 or 2+ above in dipstick for 3 consecutive days
Relapse
> =2 relapse in 6mos after initial therapy or 4 relapses in a 12 month period
Frequent relapse
