Nephrotic Syndrome
A clinical state characterized by massive proteinuria, hypoalbuminemia, generalized edema, and hyperlipidemia.
1. The Nephrotic “Tetrad.”
| Clinical Feature | Pathophysiology |
|---|---|
| Massive Proteinuria | Increased glomerular capillary wall permeability. |
| Hypoalbuminemia | Secondary to urinary loss > hepatic synthesis. |
| Edema | Low plasma oncotic pressure + sodium retention. |
| Hyperlipidemia | Increased hepatic lipid synthesis. |
2. Management Pearls
- Corticosteroids: Prednisolone is the first-line treatment for Minimal Change Disease (the most common cause in children).
- Supportive Care: Salt restriction, diuretics (if symptomatic edema), and ACE inhibitors to reduce proteinuria.
- Complications: High risk of thromboembolism (due to loss of Antithrombin III) and infections (due to loss of IgG).
NEET PG Hint: Minimal Change Disease is often termed “nil disease” because light microscopy appears normal. Electron microscopy is required to visualize the characteristic effacement of podocyte foot processes. Always suspect secondary causes if the patient is older or has hematuria and hypertension.