• Nephrotic syndrome - refers to a distinct entity with clinical and laboratory features consisting of:
  1. Nephrotic range proteinuria - greater than 3.5g/24 hours 
  2. Hypoalbuminemia - less than 3g/dL
  3. Peripheral edema
  
  Hyperlipidemia and thrombotic disease are also frequently observed as part of the nephrotic syndrome but not required to meet the definition
  
  

  Posted 07/21/16 10:06:45 AM by Anna Krigel

• Spot urine protein to spot urine Cr ratio can be used as an estimate for 24 hour urine protein excretion because urinary Cr excretion in the presence of a stable GFR is fairly constant in a given patient (often 1g Cr per day)
  
  

  Posted 07/21/16 10:16:03 AM by Anna Krigel

• Etiologies of nephrotic syndrome in adults
  
  
  • About 30% of adults will have a systemic disease like:
    • Diabetes 
    • Amyloidosis 
    • SLE
  
  
  • Remainder of cases usually due to primary renal disorders like:
    • Minimal change disease - most common cause of idiopathic nephrotic syndrome in children
    • Focal segmental glomerulosclerosis (FSGS) - accounts for 50% of cases of idiopathic nephrotic syndrome in African-American patients
    • Membranous nephropathy - can be primary or secondary to HBV, HCV, SLE, NSAIDS, syphilis, malignancy, and multiple other associations
  
  

  Posted 07/21/16 10:29:35 AM by Anna Krigel

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