Nephrotic Syndrome I : Introduction

Nephrotic syndrome is a kidney disorder characterized by increased glomerular permeability, leading to significant proteinuria, hypoalbuminemia, edema, and hyperlipidemia.

In adults, primary causes include focal segmental glomerulosclerosis, while secondary causes can be diabetes, infections such as HIV, hepatitis B and C, and medications like NSAIDs.

The pathophysiology begins with a glomerular injury, particularly affecting podocytes, which allow large amounts of protein, primarily albumin, to pass into the urine.

This protein loss results in hypoalbuminemia, which lowers blood oncotic pressure and causes fluid to shift from the bloodstream into surrounding tissues, leading to edema.

The liver then increases lipoprotein production, resulting in hyperlipidemia.

Nephrotic syndrome typically presents with morning periorbital edema that can extend to the face, limbs, and abdomen.

Severe cases may lead to generalized edema, known as anasarca, due to hypoalbuminemia. Other signs include hyperlipidemia, weight gain, fatigue, and reduced appetite.