Understanding Nephrotic syndrome, causes, pathophysiology, treatment

In the medical word or as a medical student you would have come across the world nephrotic syndrome and you may have been wondering the meaning of such word here we will be talking about the definition, pathophysiology, causes and treatment of nephrotic syndrome.

Definition; this is a syndrome caused by a derangement in glomerular capillary walls that result in increased permeability to plasma proteins and its characterised by the following 

1. Massive proteinuria - with a daily loss of 3.5 or more
2. Hypoalbumineria
3. Generalised oedema
4. Hyperlipidaemia  
5. Lipiduria

PATHOPHYSIOLOGY 

The glomerular capillary walls with its endothelium, glomerular basement, viseral epithelial cells acts asa size and charge barrier through which the plasma filtrate passes, increases permeability through this filter allow protein to escape from plasma into the urinary space resulting in proteinuria and heavy proteinuria causes hypoalbumineria  and generalised oedema (this is a direct consequence of decreased intravascular colloid osmotic pressure.

CAUSES OF NEPHROTIC SYNDROME

1. Primary glomerular diseases

        - Membrane nephropathy

        - Minimal change disease

        - Focal segmental glomerulosclerosis

        - membranoproliferative glomerulonephritis 

1. Systemic disease   

        - Diabetes 

        - Amyloidosis 

        - Drugs. (NSAIDS)

        - Infection 

        - Malignant disease (carcinoma)

TREATMENT OF NEPHROTIC SYNDROME

1. Diuretics
2. Cholesterols 
3. Angiotensin-converting enzyme inhibitors 
4. Immune system suppressing drugs
5. Corticosteroids