+nephrotic Syndrome
+nephrotic Syndrome
+nephrotic Syndrome
MASHUK
Nephrotic Syndrome
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❑ Introduction
es ❖ Nephrotic syndrome is kidney disease with proteinuria, hypoalbuminemia,
is and edema. Nephrotic-range proteinuria is 3.5 grams per day or more.
❖ There are many specific causes of nephrotic syndrome. These include
kidney diseases such as minimal-change nephropathy, focal
glomerulosclerosis, and membranous nephropathy. Nephrotic syndrome
can also result from systemic diseases that affect other organs in addition
to the kidneys, such as diabetes, amyloidosis, and lupus erythematosus.
Nephrotic Syndrome
❖ Nephrotic syndrome may affect adults and children, of both sexes and of
any race. It may occur in typical form, or in association with nephritic
syndrome. The latter it can leads glomerular inflammation, with hematuria
and impaired kidney function.
Nephrotic Syndrome
❑Classification
❖Nephrotic syndrome can be primary, being a disease specific to the kidneys, or it can be
secondary, being a renal manifestation of a systemic general illness. In all cases, injury to
glomeruli is an essential feature.
❖Primary causes of nephrotic syndrome include the following, in approximate order of frequency:
⮚Minimal-change nephropathy (etiology is not known controlled/ mediated by T cells,
lymphokines is released mre and it increase the permeability of podocytes leading to
protein loss, occur in mostly children )
⮚Focal glomerulosclerosis (does not involve whole nephron like in segment , there is
scar formation leading to fibrosed area, and leads to protein loss through proteinuria
also haematuria can by rupture of small arterioles )
⮚Membranous nephropathy( due to complement activation ie C5-9 (C5b) it activates
MAC leads to release of protease and antioxidant leading to damage to nephron and
lead to nephrotic syndrome )/ immune complex deposition
⮚Hereditary nephropathies (
Nephrotic Syndrome
❖ Secondary causes include the following, again in order of approximate
frequency:
⮚ Diabetes mellitus (if for prolonged time , increased free sugar develop in
small arterial leading aneurysm and it can also rupture and leading to
protein leakage , can develop diabetic nephropathy)
⮚ Lupus erythematosus (the autoantibody can cause inflammatory changes,
ischemic necrosis at nephron)
⮚ Amyloidosis.(huge protein production leads to destruction of basement
membrane)
⮚ Viral infections (eg, hepatitis B, hepatitis C, human immunodeficiency
virus [HIV] ) (antigen antibody complex damage glomerular membrane )
Nephrotic Syndrome
❑Other Causes of nephrotic syndrome:
❖ Blood clot in a kidney vein. (blocking arteries leading to ischemia hence
necrosis membrane damages )
❖ Heart failure. (thromboembolism can occur blocking the arteries leading
to decreased blood perfusion there at nephron )
Nephrotic Syndrome
❑ Pathophysiology:
❖ NS is believed to have an immune pathogenesis. Studies have shown
abnormal regulation of T-cell subsets and expression of a circulating
glomerular permeability factor.