This document provides information on nephrotic syndrome, including its definition, causes, clinical manifestations, diagnostic evaluation, management, and nursing considerations. Nephrotic syndrome is a kidney disorder characterized by large amounts of protein in the urine (proteinuria), low albumin levels, high cholesterol, and edema. It results from increased permeability of the glomerulus in the kidney. Common causes include primary glomerular diseases, diabetes, infections, and cancers. Signs and symptoms include proteinuria, hyperlipidemia, hypoalbuminemia, and edema. Diagnostic evaluation includes urine tests, blood tests of kidney and liver function. Management involves treating any underlying cause, using diuretics, steroids, and a diet

1. WELCOMEGHG

2. NEPHROTIC
SYNDROMEfhfh

3. INTRODUCTION
Nephrotic syndrome is a kidney disorder of four signs
symptoms making syndrome large
proteinuria,hypoalbuminaemia, hyperlipidamia,
oedema
Nephrotic syndrome results when the
glomerulus as more permeable to plasma
protein

4. DEFINITION
Nephrotic syndrome is a disorder characterized by
heavy proteinuria with hyperlipidemia or edema.
Or
Acute nephrotic syndrome is the clinical manifestation
of glomerulus
Inflammation that lead to
proteinuria,hypoalbuminia,hyperlipidemia or oedema

5. CAUSES
PRIMARY GLOMERULAR DISESASE
Inherited nephrotic syndrome
MULTI SYSTEM DISEASE
Diabetes mellitus
Amyloidosis
INFECTION
Bacterial (streptococcal)
Viral (hepatitis ,HIV)
NEOPLASM
Hodgkins lymphoma
Solid tumor of lungs and colon

6. PATHOPHYSIOLOGYDue to inflammation of glomerular capillaries.
Abnormal permeability of glomerular basal membrane.
Then protein(Albumin’s filtrate in urine proteinuria)
Decrease serum albumin level(hypoalbuminemia)
Liver synthesis more lipoprotein(Triglycerides)
Hyperlipidemia
Albumin decrease in blood
Fluid come extracellular space

7. CLINICAL MANIFESTATION
Four main symptoms are
proteinuria
Hyperlipidemia
Hypoalbuminemia
Oedema
Others
Shortness of breath weakness.
Anorexia
Anemia due to loss of red blood cell
Fatigue
Mild headache
Malaise
Weight gain
Flank pain

8. DIAGNOSTIC EVALUATION
• Palpation -due to oedema and ascites kidney not palpable
• Urinalysis
• Haematuria
• Proteinuria
• Blood test
• S.creatnine
• S.Cholesterol
• S.protein

9. Complication
• HYPOVOLEMIA
• THROMBOEMBOLIC COMPLICATION
• RENAL FAILURE
• PROTEIN ENERGY MALNUTRITION
• PULMONARY EDEMA
• HYPERTENSION
• ATHEROSCLEROSIS

10. MANAGEMENT
MEDICAL MANAGEMENT
If causative agent is Streptoccocal then treated with penicillin antibiotics
IF Autoimmune reaction is cause then provide immune suppressive therapy …
e.g.steroids
Diuretics (to reduce oedema ..eg Lasix
Beta blockers are given in case of hypertension .eg acebutolol
Calcium cannel blocker eg felodiphine

11. Dietary management
A balanced diet adequate in protein and calories is
recommended(1.5-2g/kg)
Patient with persistent proteinuria should receives 2-
2.5gkg of protein daily
Don’t give more than 30% calorie diet
Treatment with corticosteroid stimulates appetite and
adequate physical activity
Salt restriction is not necessary

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•Reduction of salt intake (1-2g/day)in case of edema
while giving sodium diet fluid restriction is essential to
prevent oedema
Provide fresh or frozen fruits (watermelon,oranges,bananas)
Low sodium diet is given because it causes fluid retention and salt
retention

13. Nursing management
• Monitor intake and output ,and measure body weight daily
• Monitor blood pressure
• Nurse should instruct or assist in changes of position
frequently to decrease pressure on edematous site
• Instruct client to wear loose fitting cotton garments to
decrease irritation .
• Provide medication as per prescription of doctor
• Promote good handwashing technique by patient to avoid
risk of cross contamination

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•Provide diuretics or drugs as per
prescription
•Instruct patient to elevate legs if oedema is
there it promote venous return
•Keep linen dry and urinate free to reduce
dermal irritation

15. NURSING DIAGNOSIS
Risk of infection related to immunosuppressive
drugs
Excess fluid volume related TO oedema
Altered nutrition related to anorexia
Knowledge deficit related to prognosis ,treatment
and self care.

16. THANKS