- Proteinuria (Albuminuria) > 40 mg/l2/hr (or > 2g /day )
- Hypoproteinemia < 2.5 g/dl
- Hyperlipidemia (Serum cholesterol > 200 mg/dl)
=> 85 % cases are Minimal change disease.
Electron microscopy shows effacement of foot process of podocytes.
=> In Adults Most common is Membranous glomerulonephritis (can have Renal vein thrombosis)
=> Mostly nephrotic syndrome is steroid sensitive, thus DOC - Prednisolone.
Clinical features :
- Loss of Ig in urine - thus infections (Most common Spontaneous bacterial peritonitis - cause Pneumococcus ) (DOC - Cefotaxime)
- Loss of Protein C and S (thus risk of thrombosis)
Most common cause of steroid resistant nephrotic - FSGS
- NPHS 1 - Nephrin ( Mutation causes FINNISH syndrome)
- NPHS 2 - Podocin ( Mutation causes steroid resistant nephrotic syndrome)
DOC for steroid resistant nephrotic :
- Tacrolimus ( Its Calcineurin inhibitor )
- Other Calcineurin inhibitor is Cyclosporin - Side effect Acne , Gingival hyperplasia
Both are nephrotoxic.
- Rituximab (Monoclonal Antibody against CD 20)
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