Definition Classification Etiology Pathology Pathophysiology Clinical Manifestation Complication Laboratory Data Diagnosis Treatment Main Contents
Male patient, 4 years old, Complaint of : edema , oliguria and proteinuria for 7 days.
Nephrotic syndrome (NS) results from increased permeability of glomerular basement membrane ( GBM ) to plasma protein. It is a syndrome characterized by massive proteinuria, hypo-albuminemia, hyper-cholesterolemia ， Hypercoagulable state and pitting edema. (4-increase, 1-decrease). Definition
If the damage of glomeruli is mild and the permeability is not so high , only lower molecular weight protein ( such as albumin, transferrin) can pass through the GBM, which is called selective proteinuria ;
If the damage of glomeruli is severe , both small and large proteins （ such as IgG, IgA ） can all pass through the GBM, which is called non-selective proteinuria .
Pathophysiology : pathogenesis of hypoalbuminemia
Loss of plasma protein from urine
Loss of extrarenal , such as from intestine
Increased catabolism of protein in renal tubules
Pathophysiology : pathogenesis of hyperlipidemia
Hypoalbuminemia -> synthesis of generalized
protein ( including lipoprotein ) and lipid in
the liver -> hyperlipidemia
Lipoprotein levels and all serum lipid (including cholesterol , triglycerides ) are increased
1.What is nephrotic syndrome ？ 2.What are the main clinical types of INS ? 3.What is the diagnostic criteria of INS ？ 4.What are the pathological types of INS ? 5.What are the common complications of INS ？ 6.How do you treat INS (general principles) ？ 7.How do you evaluate the response of steroid therapy ？ Questions