Renal physiology

1. Nephrotic Syndrome
Dr. Asad Mehmood

2. LEARNING OBJECTIVES
At the end of the lecture, students would be
able to
• Definition of nephrotic syndrome
• Enlist etiological factors of nephrotic
syndrome
• Explain pathophysiology of each cause of
nephrotic syndrome

3. Nephrotic Syndrome—Excretion of Protein in the
Urine Because of Increased Glomerular
Permeability
• Nephrotic syndrome is a group of symptoms
that indicate your kidneys are not working
properly.
• These symptoms include. too much protein in
your urine, called proteinuria. low levels of a
protein called albumin in your blood, called
hypoalbuminemia. swelling in parts of your
body, called edema.

6. Nephrotic syndrome is usually caused by damage to the
clusters of small blood vessels in your kidneys that filter
waste and excess water from your blood.
Main causes include
(1) chronic glomerulonephritis,
(2) amyloidosis, which is deposition of an
abnormal proteinoid substance in the walls of the blood
vessels that damages the basement membrane of the
glomeruli;
(3) minimal change nephrotic syndrome, loss of the
negative charges that are normally present in the
glomerular capillary basement membrane.
Albuminurine

9. Nephrotic syndrome
• Occurs in children between the ages of 2 and 6 years.
• Increased permeability of the glomerular capillary
membrane allows as much as 40 grams of plasma protein
loss into the urine each day,.
• The child’s plasma protein concentration often falls below
2 g/dl, and the colloid osmotic pressure falls from a
normal value of 28 to less than 10 mm Hg.
• Due to this low colloid osmotic pressure in the plasma,
large amounts of fluid leak from the capillaries all over the
body into most of the tissues, causing edema