Nephrotic syndrome

Last updated: Thursday, 23, December, 2010
CausesAppropriate Tests

Usually defined as urinary protein > 3g per day, with hypoalbuminaemia, generalised oedema and, usually, hyperlipidaemia.

Random urine protein and creatinine (protein/creatinine ratio) is generally sufficient to establish the diagnosis, although 24 hour collections are traditionally used.

Albumin, protein (total); cholesterol, triglycerides; urea, creatinine, electrolytes, eGFR.

Other useful tests include urine microscopy (cell count, red cell morphology); FBC and blood film.

Renal loss of immunoglobulins and complement components may predispose to infection.

Primary glomerular disease

Glomerulonephritis, especially

  • Minimal change disease (children)
  • Primary membranes GN

Hereditary nephropathies

  • Alport syndrome

Glomerulopathy associated with other diseases

Diabetes mellitus

SLE

Drug reactions

  • NSAID
  • Gold
  • Captopril

Infections

Neoplasia

Amyloidosis