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{{Nephrotic syndrome}}
{{Nephrotic syndrome}}
{{CMG}}; {{AE}} [[User:YazanDaaboul|Yazan Daaboul]], [[User:Sergekorjian|Serge Korjian]]
{{CMG}}, {{APM}}; {{AE}} {{OO}}, [[User:YazanDaaboul|Yazan Daaboul]], [[User:Sergekorjian|Serge Korjian]]


==Overview==
==Overview==
Nephrotic syndrome can be classified into primary or secondary depending on the underlying etiology.  Primary (idiopathic) nephrotic syndrome is defined as nephrotic syndrome due to a primary [[glomerular]] disease. Secondary nephrotic syndrome is defined as nephrotic syndrome due to a primary etiology other than glomerular disorders, such as [[infection]]s, [[malignancies]], systemic conditions, and [[medication]]s.
Nephrotic syndrome can be classified into primary or secondary depending on the underlying etiology.  Primary (idiopathic) nephrotic syndrome is defined as nephrotic syndrome due to a primary [[glomerular]] disease. The secondary nephrotic syndrome is defined as nephrotic syndrome due to a primary etiology other than glomerular disorders, such as [[infection]]s, [[malignancies]], systemic conditions, and [[medication]]s.


==Classification==
==Classification==
===Etiologic Classification===
* Nephrotic syndrome can be classified into primary or secondary depending on the underlying etiology.<ref name="pmid19904897">{{cite journal| author=Kodner C| title=Nephrotic syndrome in adults: diagnosis and management. | journal=Am Fam Physician | year= 2009 | volume= 80 | issue= 10 | pages= 1129-34 | pmid=19904897 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19904897 }} </ref>
Nephrotic syndrome can be classified into primary or secondary depending on the underlying etiology.
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====Primary (Idiopathic) Nephrotic Syndrome====
* Below table lists different types of nephrotic syndromes:<ref name="pmid10793022">{{cite journal |vauthors=Braden GL, Mulhern JG, O'Shea MH, Nash SV, Ucci AA, Germain MJ |title=Changing incidence of glomerular diseases in adults |journal=Am. J. Kidney Dis. |volume=35 |issue=5 |pages=878–83 |date=May 2000 |pmid=10793022 |doi= |url=}}</ref><ref name="pmid15327377">{{cite journal |vauthors=Heaf J |title=The Danish Renal Biopsy Register |journal=Kidney Int. |volume=66 |issue=3 |pages=895–7 |date=September 2004 |pmid=15327377 |doi=10.1111/j.1523-1755.2004.00832.x |url=}}</ref><ref name="pmid28392820">{{cite journal |vauthors=Ha TS |title=Genetics of hereditary nephrotic syndrome: a clinical review |journal=Korean J Pediatr |volume=60 |issue=3 |pages=55–63 |date=March 2017 |pmid=28392820 |pmc=5383633 |doi=10.3345/kjp.2017.60.3.55 |url=}}</ref>
Primary (idiopathic) nephrotic syndrome is defined as nephrotic syndrome due to a primary glomerular disease. It is a common diagnosis in children. Etiologies of idiopathic nephrotic syndrome include:<ref name="pmid19904897">{{cite journal| author=Kodner C| title=Nephrotic syndrome in adults: diagnosis and management. | journal=Am Fam Physician | year= 2009 | volume= 80 | issue= 10 | pages= 1129-34 | pmid=19904897 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19904897 }} </ref>:
{|
*[[Minimal change disease]]
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Different types of nephrotic syndromes
*[[Focal segmental glomerulosclerosis]] (FSGS)
! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease name
*[[Membranous nephropathy]]
|-
*[[Membranoproliferative glomerulonephritis]]
! rowspan="6" align="center" style="background:#DCDCDC;" + |Podocytopathies
*[[IgM nephropathy]]
| rowspan="2" align="left" style="background:#F5F5F5;" + |Primary
*C1q nephropathy
| align="left" style="background:#F5F5F5;" + |[[Minimal change disease]]
 
|-
====Secondary Nephrotic Syndrome====
| align="left" style="background:#F5F5F5;" + |[[Focal segmental glomerulosclerosis]] ([[Focal segmental glomerulosclerosis|FSGS]])
Secondary nephrotic syndrome is defined as nephrotic syndrome due to a primary etiology other than glomerular disorders, such as [[infection]]s, [[malignancies]], systemic conditions, and [[medication]]s. The most common cause of secondary nephrotic syndrome is [[diabetes mellitus]].
|-
 
| rowspan="4" align="left" style="background:#F5F5F5;" + |Secondary
{| border="1" style="border-collapse:collapse; text-align:left;" cellpadding="5" align="center"
| align="left" style="background:#F5F5F5;" + |Infection such as:
|+ '''''Common Causes of Secondary Nephrotic Syndrome<ref name="pmid18497417">{{cite journal| author=Hull RP, Goldsmith DJ| title=Nephrotic syndrome in adults. | journal=BMJ | year= 2008 | volume= 336 | issue= 7654 | pages= 1185-9 | pmid=18497417 | doi=10.1136/bmj.39576.709711.80 | pmc=PMC2394708 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18497417 }} </ref><ref name="pmid19904897">{{cite journal| author=Kodner C| title=Nephrotic syndrome in adults: diagnosis and management. | journal=Am Fam Physician | year= 2009 | volume= 80 | issue= 10 | pages= 1129-34 | pmid=19904897 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19904897 }} </ref>'''''
* [[Human Immunodeficiency Virus (HIV)|HIV]]
| bgcolor="#d9ff54"|'''Cause''' || bgcolor="#d9ff54"|'''Characteristic Features'''
|-
| align="left" style="background:#F5F5F5;" + |Drugs/toxins such as:
* [[Non-steroidal anti-inflammatory drug|NSAIDs]]
* Interferon
* Pamidronate
* Lithium
* Vaccins
* Envenomation
|-
|-
| bgcolor="#ececec"|'''Diabetes Mellitus''' ||
| align="left" style="background:#F5F5F5;" + |Malignancies such as:
*[[Glucosuria]]
* [[Hodgkin's lymphoma|Hodgkin lymphoma]]
*[[Hyperglycemia]]
* [[Thymoma]]
*[[Polyuria]]
*[[Polydipsia]]
|-
|-
| bgcolor="#ececec"|'''Systemic Lupus Erythematosus (SLE)''' ||
| align="left" style="background:#F5F5F5;" + |Genetic disorders such as:
*[[Anemia]]
* [[Nephrin]] mutations
*[[Arthralgia]]
* [[Podocin]] gene mutations
*[[Malar rash|Malar]] or [[discoid rash]]
*[[Photosensitivity]]
*Neurological, renal, immunologic disease
*[[Pleural effusion or ascites
*Positive [[ANA]] and [[anti-dsDNA]] antibodies
|-
|-
| bgcolor="#ececec"|'''Viral Hepatitis (HBV and HCV)''' ||
! rowspan="2" align="center" style="background:#DCDCDC;" + |[[Membranous glomerulonephritis]]
*Elevated [[liver function test]]s
| align="left" style="background:#F5F5F5;" + |Primary
*History of transfusions
| align="left" style="background:#F5F5F5;" + |[[Membranous nephritis|Membranous nephropathy]]
*High-risk sexual encounters
*IV drug use
*Positive HBsAg or [[HCV]] RNA
|-
|-
| bgcolor="#ececec"|'''NSAIDs''' ||
| align="left" style="background:#F5F5F5;" + |Secondary
*Associated with minimal change disease (MCD)
| align="left" style="background:#F5F5F5;" + |
* [[Drugs]]
* [[Toxin|Toxins]]
* [[Cancer|Malignancies]]
|-
|-
|bgcolor="#ececec"|'''Amyloidosis''' ||
! align="center" style="background:#DCDCDC;" + |[[Membranoproliferative glomerulonephritis]]
 
| align="left" style="background:#F5F5F5;" + |Secondary
*[[Cardiomyopathy]]
| align="left" style="background:#F5F5F5;" + |
*[[Hepatomegaly]]
* Autoimmune disorders such as:
*[[Peripheral neuropathy]]
** [[SLE]]
** Aquired [[C3 glomerulopathy]]
* Infections such as:
** [[Hepatitis C|HCV]]
** [[Endocarditis]]
* [[Genetics]]
* [[Malignancies]]  
* [[Thrombotic microangiopathy]]
|-
|-
| bgcolor="#ececec"|'''Multiple Myeloma''' ||
! align="center" style="background:#DCDCDC;" + |Hereditary Nephropathy
*Abrnomal urine protein electrophoresis (UPEP) and serum protein electrophoresis (SPEP)
| colspan="2" align="left" style="background:#F5F5F5;" + |
*[[Back pain]]
* [[Alport syndrome]]
*[[Renal failure]]
* [[IgA nephropathy]]
*[[Anemia]]
* C1q nephropathy
*[[Hypercalcemia]]
*Positive serum beta-2-microglobulin
|-
|-
| bgcolor="#ececec"|'''HIV''' ||
! align="center" style="background:#DCDCDC;" + |[[Glomerular deposition disease|Glomerular deposition diseases]]
*Reduced [[CD4]] cell counts
| colspan="2" align="left" style="background:#F5F5F5;" + |
*High-risk sexual encounters
* [[Diabetes mellitus]]
*History of transfusions
* [[Amyloidosis]]
*History of drug use
* [[Monoclonal antibodies|Monoclonal]] deposition disease
*Renal pathology similar to [[focal segmental glomerulosclerosis]] (FSGS)
* Nodular glomeruloneohritis associated with heavy [[smoking]]
|-
|-
| bgcolor="#ececec"|'''Preeclampsia''' ||
! align="center" style="background:#DCDCDC;" + |Others
*[[High blood pressure]], [[edema]], and [[proteinuria]] during pregnancy
| colspan="2" align="left" style="background:#F5F5F5;" + |
* [[Fabry's disease|Fabry disease]]
* [[Nail-patella syndrome]]
* [[Lipodystrophy|Partial lipodystrophy]]
* [[Pre-eclampsia|Preeclampsia]]
|}
|}
<center><sup>Adapted from Hull RP, Goldsmith DJ. Nephrotic syndrome in adults. BMJ. 2008; 336:1185-9</sup></center>
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Kidney diseases]]
 
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[[Category:Urology]]
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Syndromes]]
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[[Category:Needs overview]]
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Latest revision as of 22:57, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Ali Poyan Mehr, M.D. [2]; Associate Editor(s)-in-Chief: Olufunmilola Olubukola M.D.[3], Yazan Daaboul, Serge Korjian

Overview

Nephrotic syndrome can be classified into primary or secondary depending on the underlying etiology. Primary (idiopathic) nephrotic syndrome is defined as nephrotic syndrome due to a primary glomerular disease. The secondary nephrotic syndrome is defined as nephrotic syndrome due to a primary etiology other than glomerular disorders, such as infections, malignancies, systemic conditions, and medications.

Classification

  • Nephrotic syndrome can be classified into primary or secondary depending on the underlying etiology.[1]
 
 
 
Nephrotic
syndrome
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Primary
 
 
 
Secondary
  • Below table lists different types of nephrotic syndromes:[2][3][4]
Different types of nephrotic syndromes Disease name
Podocytopathies Primary Minimal change disease
Focal segmental glomerulosclerosis (FSGS)
Secondary Infection such as:
Drugs/toxins such as:
  • NSAIDs
  • Interferon
  • Pamidronate
  • Lithium
  • Vaccins
  • Envenomation
Malignancies such as:
Genetic disorders such as:
Membranous glomerulonephritis Primary Membranous nephropathy
Secondary
Membranoproliferative glomerulonephritis Secondary
Hereditary Nephropathy
Glomerular deposition diseases
Others

References

  1. ↑ Kodner C (2009). "Nephrotic syndrome in adults: diagnosis and management". Am Fam Physician. 80 (10): 1129–34. PMID 19904897.
  2. ↑ Braden GL, Mulhern JG, O'Shea MH, Nash SV, Ucci AA, Germain MJ (May 2000). "Changing incidence of glomerular diseases in adults". Am. J. Kidney Dis. 35 (5): 878–83. PMID 10793022.
  3. ↑ Heaf J (September 2004). "The Danish Renal Biopsy Register". Kidney Int. 66 (3): 895–7. doi:10.1111/j.1523-1755.2004.00832.x. PMID 15327377.
  4. ↑ Ha TS (March 2017). "Genetics of hereditary nephrotic syndrome: a clinical review". Korean J Pediatr. 60 (3): 55–63. doi:10.3345/kjp.2017.60.3.55. PMC 5383633. PMID 28392820.
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