Nephrotic syndrome
Clinical syndrome with gross proteinuria and hypoalbuminaemia.
Oedema and hyperlipaemia is severe.
Hypertension might be developed.
Children disease – ‘idiopathic’
Pathology
4 different types depend on appearance.
Some with minimal changes, some with grater changes.
80% cases are minimal change – response to treatment.
Clinical features
Preschool chid
Oedema – swelling in face, leg and abdomen.
Ascites
Protein urea – heavy.
Hypertension might develop later.
Biochemical features
Reduction of total serum protein
Main reduction is albumin.
Reduction of gamma globulin.
High serum cholesterol.
Progress
Most recover completely.
Some might get relapses.
Might develop to renal failure.
Infection - due to low gamma globulin.
Treatment
Steroids – prednisolone for long duration.
At the beginning fluid intake can be reduced with low sodium intake.
Increase protein intake.
Relapses are common.
Careful about side effect of steroids.
Immunosuppressive drugs.