Massive Protein Loss in Urine: Nephrotic syndrome is marked by a significant leakage of proteins (more than 3.5 grams per day) into the urine, leading to foamy or frothy urine due to damaged glomeruli that can no longer retain proteins.
Hypoalbuminemia: This condition involves low levels of albumin in the blood because of protein loss. It contributes to decreased blood oncotic pressure, resulting in fluid leakage into tissues.
Edema: Swelling, particularly in the legs, feet, and around the eyes, is a common symptom due to fluid retention in the tissues. This is often most noticeable in the morning.
Hyperlipidemia: To compensate for the loss of proteins, the liver produces more fats, leading to high levels of lipids in the blood. These fats can also cause fluid retention and appear as fat globules in the urine, known as oval fat bodies under the microscope.
Common Causes: Nephrotic syndrome can be caused by various conditions:
Minimal Change Disease: Most common in children, characterized by an unclear cause but generally wellmanaged with corticosteroids.
Focal Segmental Glomerulosclerosis (FSGS): Involves scarring of the glomeruli, common in adults, often requiring immunosuppressants.
Diabetic Nephropathy: A complication of longterm diabetes, leading to chronic kidney disease.
Other Causes: Includes systemic lupus erythematosus and membranous nephropathy.
Nephritic Syndrome Highlights:
Hematuria: The hallmark of nephritic syndrome is the presence of blood in the urine due to inflammation and damage to the glomeruli. This can be visible to the naked eye or detected microscopically.
Oliguria and Azotemia: Reduced urine output (oliguria) and increased nitrogenous waste products (azotemia) in the blood indicate impaired kidney function and filtration problems.
Hypertension: High blood pressure is common due to the kidneys' inability to filter blood properly and the activation of the reninangiotensinaldosterone system, which increases blood pressure.
Common Causes: Nephritic syndrome can arise from various conditions:
Postinfectious Glomerulonephritis: Often follows a streptococcal infection, particularly in children.
IgA Nephropathy: Involves the deposition of IgA antibodies in the glomeruli, leading to inflammation.
Rapidly Progressive Glomerulonephritis: Often associated with autoimmune diseases like Goodpasture syndrome and lupus nephritis.
Treatment Principles:
Treatment Approaches: Managing nephrotic and nephritic syndromes involves addressing the underlying causes and symptomatic relief:
Nephrotic Syndrome: Use of ACE inhibitors or ARBs to reduce proteinuria, diuretics to manage edema, dietary adjustments to control sodium and fat intake, anticoagulants to prevent thrombosis, and corticosteroids or immunosuppressants for autoimmune conditions.
Nephritic Syndrome: Focuses on treating the root cause, which may involve plasmapheresis to remove harmful antibodies, alongside supportive treatments similar to those for nephrotic syndrome.
Disclaimer:
This information is provided for general knowledge and educational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult with your doctor for any questions or concerns you may have about your health.
By James Heilman, MD Own work, CC BYSA 3.0, https://commons.wikimedia.org/w/index...
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