- A PRESENTATION BY NAYEEM AHMED
What is Nephrotic Syndrome ?
NEPHROTIC SYNDROME IS A
NONSPECIFIC KIDNEY DISORDER CHARACTERISED
BY A NUMBER OF SIGNS
OF DISEASE: PROTEINURIA, HYPOALBUMINEMIA
NEPHROTIC SYNDROME (NS) RESULTS
FROM INCREASED PERMEABILITY OF
GLOMERULAR BASEMENT MEMBRANE
(GBM) TO PLASMA PROTEIN.
The Main Trigger Of primary
Nephrotic Syndrome and
Fundamental and highly
important change of
Nephrotic Syndrome (Nephrosis)
It is clinical and
NS in a
• Generalized edema
A group of diseases resulting
from abnormal deposition of certain
proteins (amyloids) in various bodily
Is a kidney disorder that leads
to changes and inflammation of the
structures inside the kidney that
help filter wastes and fluids.
Foot Process Disease:
In minimal change disease, there is
damage to the glomeruli
Primary Idiopathic NS (INS): majority
The cause is still unclear up to now. Recent 10 years evidence has
suggested that INS may result from a primary disorder of T– cell
Accounting for 90% of NS in child.
Congenital NS: rare
1st 3 month of life, only treatment renal transplantation.
Nephrotic syndrome is 15 times more common in children than in
Most cases of primary nephrotic syndrome are in children and are
due to minimal-change disease.
*Massive proteinuria :
qualitative proteinuria: 3+ or 4+,
quantitative proteinuria : more than 3.5gms/day in children (selective).
total plasma proteins < 5.5g/dl and serum albumin : < 2.5g/dl.
serum cholesterol : > 5.7mmol/L
pitting edema in different degree
Reduced oncotic pressure
Reduced blood volume
Activation of RAAS
Response to Hypoproteinemia
→ reflex to liver --→ synthesis
of generalize protein
( including lipoprotein ) and
lipid in the liver ,the
lipoprotein high molecular
weight no loss in urine →
*Diminished catabolism of
Edema (varying degrees) is the common symptom
Local edema: edema in face , around eyes( Periorbital swelling) , in lower extremities.
Generalized edema (anasarca), edema in penis and scrotum.
Fatigue and lethargy
loss of appetite
nausea and vomiting
body weight increase
urine output decrease
pleural effusion (respiratory distress)
Examples of Clinical Menifestations
Management of Nephrotic
General (non specific)
Hypertension and edema: Low salt diet.
Severe edema: Restricting fluid intake
Prednisone is a corticosteroid.
It reduces swelling.
It is used for many conditions among them: