From the Guidelines
Nephrotic syndrome is characterized by heavy proteinuria, hypoalbuminemia, and edema, with primary causes including minimal change disease, focal segmental glomerulosclerosis, and membranous nephropathy. The symptoms of nephrotic syndrome include heavy proteinuria (≥ 1.0 g m−2 day−1 in children), hypoalbuminemia (< 3.0 g dl−1 in adults; < 40 mg m−2 h−1 in adults; < 2.5 g dl−1 in children), and edema, as well as hypercholesterolemia 1.
Causes of Nephrotic Syndrome
- Primary glomerular disease of idiopathic cause
- Minimal change disease (MCD)
- Focal segmental glomerulosclerosis (FSGS)
- Membranous nephropathy
Symptoms of Nephrotic Syndrome
- Heavy proteinuria (≥ 1.0 g m−2 day−1 in children)
- Hypoalbuminemia (< 3.0 g dl−1 in adults; < 40 mg m−2 h−1 in adults; < 2.5 g dl−1 in children)
- Edema
- Hypercholesterolemia The definition of nephrotic syndrome includes the presence of heavy proteinuria (≥ 3.5 g day−1), hypoalbuminemia, and edema, with hypercholesterolemia commonly present 1.
Key Characteristics
- Heavy proteinuria: ≥ 1.0 g m−2 day−1 in children
- Hypoalbuminemia: < 3.0 g dl−1 in adults; < 40 mg m−2 h−1 in adults; < 2.5 g dl−1 in children
- Edema
- Hypercholesterolemia It is essential to identify the underlying cause of nephrotic syndrome through kidney biopsy when appropriate, as treatment depends on the primary cause 1.
From the FDA Drug Label
To induce a diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus The causes of Nephrotic Syndrome mentioned are:
- Idiopathic type
- Due to lupus erythematosus The symptom of Nephrotic Syndrome mentioned is:
- Proteinuria 2
From the Research
Causes of Nephrotic Syndrome
- Primary causes in children: idiopathic minimal change disease and focal segmental glomerulosclerosis (FSGS) 3
- Primary causes in adults: FSGS and membranous nephropathy (MN) 3, 4
- Secondary causes: diabetes, amyloidosis, systemic lupus erythematosus, hematologic malignancies, and infections 3, 4, 5
Symptoms of Nephrotic Syndrome
- Edema, proteinuria, hypoalbuminemia, and hyperlipidemia 3, 4, 5
- Periorbital oedema and dependent pitting oedema 4
- Thromboembolism and increased risk of infection 4, 5
Diagnosis of Nephrotic Syndrome
- Confirmation of diagnosis by measuring proteinuria and serum albumin and lipid levels 3
- Evaluation to assess for secondary causes 3
- Renal biopsy to establish the form of glomerular disease responsible 4, 5
- Urine protein: creatinine ratio (PCR) or albumin: creatinine ratio (ACR) to document proteinuria 4
Treatment of Nephrotic Syndrome
- Glucocorticoid treatment for children and some adults 3, 5
- Alternative therapies for frequent recurrences, steroid-resistant cases, and steroid-dependent cases 3, 6, 7
- Dietary sodium restriction, edema management, and blood pressure control for long-term management 3, 5
- Thromboembolism prophylaxis for patients with high risk of thromboembolism 3