Nephrotic syndrome results from loss of plasma proteins in the urine and characterized by hypoalbuminemia, hyperalbuminuria, hyperlipidemia, and edema. It may be caused by primary (idiopathic) renal disease or by a variety of secondary causes.
Patients present with marked edema, proteinuria, hypoalbuminemia, and often hyperlipidemia .
It may be classified as congenital or acquired :
- minimal-change glomerular disease (MCGD)
- focal segmental glomerulosclerosis (FSGS)
- membranous glomerular disease
- membranoproliferative glomerular disease
- when no cause is identified the term adult idiopathic nephrotic syndrome is used
Nephrotic syndrome per se may produce non-specific appearances due to marked edema and hypoalbuminemia, e.g. anasarca, bowel wall thickening, etc. Chyluria may be seen due to the heavy losses of chyle/fats in the urine.
Treatment and prognosis
Treatment of most patients should include fluid and sodium restriction, oral or intravenous diuretics, and angiotensin-converting enzyme inhibitors . Some adults with nephrotic syndrome may benefit from corticosteroid treatment, cyclosporin A, although research data are limited . Intravenous albumin, prophylactic antibiotics, and prophylactic anticoagulation are not currently recommended .