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NEPHROTIC SYNDROME. Common Causes of Benign Proteinuria Dehydration Emotional stress Fever Heat injury Inflammatory process Intense activity Most acute illnesses Orthostatic (postural) disorder. NEPHROTIC SYNDROME. PROTEINURIA EDEMA HYPERLIPIDEMIA LIPIDURIA HYPERCOAGULABILITY. - PowerPoint PPT Presentation
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NEPHROTIC SYNDROMENEPHROTIC SYNDROME
• Common Causes of Benign Proteinuria Dehydration Emotional stress Fever Heat injury Inflammatory process Intense activity Most acute illnesses Orthostatic (postural) disorder
Classification of Proteinuria
TypePathophysiologic features
Cause
GlomerularIncreased glomerular capillary permeability to protein
Primary or secondary glomerulopathy
TubularDecreased tubular reabsorption of proteins in glomerular filtrate
Tubular or interstitial disease
OverflowIncreased production of low- molecular-weight proteins
Monoclonal gammopathy, leukemia
Cause of Proteinuria as Related to Quantity
Daily protein excretionCause
0.15 to 2.0 gMild glomerulopathiesTubular proteinuriaOverflow proteinuria
2.0 to 4.0 gUsually glomerular
>4.0 gAlways glomerular
NEPHROTIC SYNDROME• PROTEINURIA• EDEMA• HYPERLIPIDEMIA• LIPIDURIA• HYPERCOAGULABILITY
CAUSES OF HYPERLIPIDEMIA
• INCREASED LIPOPROTEIN SYNTHESIS
• INCREASED LOSS OF REGULATOR PROTEINS
• DEFECTIVE LIPID CATABOLISM
CAUSES OF HYPERCOAGULABILITY
• DECREASED ANTITHROMBIN III• DECREASED PROTEIN S & C• HYPERFIBRINOGENEMIA• ICREASED PLATELET
AGGREGABILITY
OTHER METABOLIC COMPLICATION
• PROTEIN MALNUTRITION• ANEMIA• HYPOCALCEMIA• DECREASED THYROXINE LEVEL• SUSCEPTIBILITY TO INFECTION
POOR PROGNOSIS FACTORS IN MGN
• MALE SEX• HYPERTENSION• DECREASED GFR• OLD AGE• SEVERE PROTEINURIA• SEVERE HYPERLIPIDEMIA
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