This document defines nephrotic syndrome as a condition characterized by proteinuria, hypoalbuminemia, edema, and hyperlipidemia caused by damage to the glomeruli in the kidneys. It lists various primary and secondary causes of nephrotic syndrome including diseases like lupus, diabetes, and infections. The clinical manifestations are edema, hyperlipidemia, and proteinuria. Treatment involves monitoring fluid levels, treating underlying causes, and using diuretics, immunosuppressants, and in some cases anticoagulants.

1. PRESENTED BY:-
PROF. VIJAYREDDY VANDALI
M. SC. (NSG), PGDHA,
DEPARTMENT OF MEDICAL–SURGICAL NURSING .
INDIA

2. DEFINITION
The term Nephrotic syndrome describes a
clinical course that can be associated with a
number of disease conditions. Nephrotic
syndrome is not a single diseases entirely
but a constellation of symptoms including
albuminuria, hypoalbuminuria, edema,
hyperlipidemia, and lipduria. This
syndrome causes damage to the glomeruli
with resultant Proteinuria.

3. KIDNEYs

4. GLOMERULUS

5. ETIOLOGY
Primary Glomeruli Disease
 Membranous proliferative
glomerulonephritis.
 Primary Nephrotic syndrome.
 Focal glomerulonephritis.
 Inherited Nephrotic syndrome.

6. CONTD…..
External causes
1) Multisystem disease
Systematic lupus erythematous
Diabetes Mellitus.
Sickle cell anemia.
Amyloidosis

7. 2)Infections
Bacterial (streptococcal, syphilis)
Viral (herpes zoster, HIV, hepatitis)
Protozoa (malaria)
3) Neoplasm
Hodgkin’s disease
Solid tumors of lung, colon, stomach
and breast.
Leukemia.

8. 4) Circulatory problems
Severe congestive heart failure
Chronic constructive Pericarditis
5) Allergic reaction
Insect bites, bee sting and pollen
Drugs (penicillamine, non steroidal
anti inflammatory drugs)

9. Clinical manifestation
It is characterized by Proteinuria
(>3.5g/day), hypoalbuminuria,
hyperlipidemia and edema which is
generalized & also known as anasarca
or dropsy. The edema begins in the
face. Lipduria (lipids in urine) can also
occur, but is not essential for the
diagnosis of Nephrotic syndrome.

10. HYPERLIPIDEMIA

11. EDEMA

13. CONTD…
Anemia
Dyspnea
Some patients may notice foamy or
frothy urine

14. Complications
Venous thrombosis
Infection
Acute renal failure
Pulmonary edema
Growth retardation
Hypovolamia

15. TREATMENT
Monitoring and maintaining
hypovolemia (the correct amount of
fluid in the body):
Monitoring urine output, BP
regularly.
Fluid restrict to 1 L.
Diuretics (IV furosemide).

16. CONTD…
Monitoring kidney function:
Do EUCs daily and calculating GFR.
Treat hyperlipidemia to prevent further
atherosclerosis.
Prophylactic anticoagulation may be
appropriate in some circumstances.

17. CONTD…
Specific treatment of underlying cause
Immunosuppressant for the
glomerulonephritides (corticosteroids,
cyclosporine).
Standard regime for first episode:
prednisolone-60 mg/m2/day in 3 divided
doses for 4 weeks followed by
40 mg/m2/day in a single dose on every
alternate day for 4 weeks.

18. CONTD…
Relapses by prednisolone 2 mg/kg/day till
urine becomes negative for protein. Then,
1.5 mg/kg/day for 4 weeks.
Frequent relapses treated by:
cyclophosphamide or nitrogen mustard or
cyclosporine or levamisole.
Achieving better blood glucose level control
if the patient is diabetic.

19. THANK YOU