From the Guidelines
Nephrotic and nephrotic syndrome are not two separate conditions, but rather "nephrotic-range" refers to the severity of proteinuria, while "nephrotic syndrome" is a clinical condition characterized by heavy proteinuria, hypoalbuminemia, edema, and hyperlipidemia. The terms "nephrotic" and "nephrotic syndrome" are often used interchangeably, but according to the Kidney Disease: Improving Global Outcomes (KDIGO) consensus conference 1, "nephrotic-range" albuminuria or proteinuria is defined as an albumin excretion rate (AER) >2200 mg/d or an albumin-creatinine ratio (ACR) >2200 mg/g, while nephrotic syndrome is a clinical condition that includes these laboratory findings along with hypoalbuminemia, edema, and hyperlipidemia.
Key differences:
- Nephrotic-range proteinuria is a laboratory finding, while nephrotic syndrome is a clinical diagnosis
- Nephrotic syndrome includes hypoalbuminemia, edema, and hyperlipidemia, in addition to heavy proteinuria
- The presence or absence of nephrotic syndrome should be specified when describing nephrotic-range albuminuria or proteinuria 1
Mnemonic to remember:
Use the phrase "NRPS" to remember the key components of nephrotic syndrome: N - Nephrotic-range proteinuria R - Reduced albumin levels (hypoalbuminemia) P - Protein leakage into the urine S - Swelling (edema) and hyperlipidemia
Table to compare:
| Term | Definition | Laboratory findings | Clinical features |
|---|---|---|---|
| Nephrotic-range | Severity of proteinuria | AER >2200 mg/d or ACR >2200 mg/g | None |
| Nephrotic syndrome | Clinical condition | AER >2200 mg/d or ACR >2200 mg/g | Hypoalbuminemia, edema, hyperlipidemia |
In clinical practice, it is essential to distinguish between nephrotic-range proteinuria and nephrotic syndrome, as the treatment approaches and prognosis may differ significantly 1.
From the Research
Definition and Characteristics
- Nephrotic syndrome is characterized by heavy proteinuria, hypoproteinemia, hypercholesterolemia, lipiduria, and edema 2.
- The glomerular filtration barrier (GFB) plays a crucial role in preventing the filtration of plasma proteins into the urine 2.
- Nephrotic-range proteinuria refers to a condition where the proteinuria is similar to that seen in nephrotic syndrome, but without the other characteristic features such as hypoproteinemia and edema 3.
Comparison of Nephrotic and Nephrotic Syndrome
- The key difference between nephrotic and nephrotic syndrome is the presence of hypoproteinemia, hypercholesterolemia, and edema in nephrotic syndrome 4.
- Nephrotic syndrome is a more severe condition that requires prompt medical attention and treatment 5.
- The following table summarizes the key differences between nephrotic and nephrotic syndrome:
Characteristic Nephrotic Nephrotic Syndrome Proteinuria Present Present Hypoproteinemia Absent Present Hypercholesterolemia Absent Present Edema Absent Present Lipiduria Absent Present
Mnemonic to Remember the Difference
- Use the mnemonic "NEPHROTIC" to remember the key features of nephrotic syndrome:
- N: Nephrotic-range proteinuria
- E: Edema
- P: Proteinuria
- H: Hypoproteinemia
- R: Renal dysfunction
- O: Oncotic pressure changes
- T: Thrombophilia
- I: Infections
- C: Cardiovascular complications
Treatment and Management
- Treatment of nephrotic syndrome typically involves a combination of corticosteroids, immunosuppressive agents, and supportive care 5.
- Management of complications such as infections, thrombophilia, and cardiovascular disease is crucial in patients with nephrotic syndrome 4.
- The use of eplerenone and enalapril has been shown to have antiproteinuric effects in patients with nephrotic syndrome 6.