0 Nephrotic Syndrome

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Nephrotic Syndrome


  • 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 :

  1. Oedema
  2. Hypovolemia
  3. Loss of Ig in urine - thus infections (Most common Spontaneous bacterial peritonitis - cause Pneumococcus ) (DOC - Cefotaxime)
  4. Loss of Protein C and S (thus risk of thrombosis)

Most common cause of steroid resistant nephrotic - FSGS

 Genetics : 
  • 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)



MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

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