Nephrotic syndrome classification: Difference between revisions

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*Hereditary Nephropathies: are group of disorders that present with both the features of nephrotic and nephritic syndromes. When features of nephritic syndrome are associated with sensorineural deafness, it is called Alport’s syndrome. Other hereditary nephropathies include IgA Nephropathy, C1q Nephropathy, etc.
*Hereditary Nephropathies: are group of disorders that present with both the features of nephrotic and nephritic syndromes. When features of nephritic syndrome are associated with sensorineural deafness, it is called Alport’s syndrome. Other hereditary nephropathies include IgA Nephropathy, C1q Nephropathy, etc.
====Secondary Nephrotic Syndrome====
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]].
{| border="1" style="border-collapse:collapse; text-align:left;" cellpadding="5" align="center"
|+ '''''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>'''''
| bgcolor="#d9ff54" |'''Cause''' || bgcolor="#d9ff54" |'''Characteristic Features'''
|-
| bgcolor="#ececec" |'''[[Diabetes Mellitus]]''' ||
*[[Glucosuria]]
*[[Hyperglycemia]]
*[[Polyuria]]
*[[Polydipsia]]
|-
| bgcolor="#ececec" |'''[[Systemic Lupus Erythematosus]] (SLE)''' ||
*[[Anemia]]
*[[Arthralgia]]
*[[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]])''' ||
*Elevated [[liver function test]]s
*History of transfusions
*High-risk sexual encounters
*IV drug use
*Positive HBsAg or [[HCV]] RNA
|-
| bgcolor="#ececec" |'''[[NSAID]]s''' ||
*Associated with minimal change disease (MCD)
|-
| bgcolor="#ececec" |'''[[Amyloidosis]]''' ||
*[[Cardiomyopathy]]
*[[Hepatomegaly]]
*[[Peripheral neuropathy]]
|-
| bgcolor="#ececec" |'''[[Multiple Myeloma]]''' ||
*Abrnomal [[urine protein electrophoresis]] (UPEP) and [[serum protein electrophoresis]] (SPEP)
*[[Back pain]]
*[[Renal failure]]
*[[Anemia]]
*[[Hypercalcemia]]
*Positive serum beta-2-microglobulin
|-
| bgcolor="#ececec" |'''[[HIV]]''' ||
*Reduced [[CD4]] cell counts
*High-risk sexual encounters
*History of transfusions
*History of drug use
*Renal pathology similar to [[focal segmental glomerulosclerosis]] (FSGS)
|-
| bgcolor="#ececec" |'''[[Preeclampsia]]''' ||
*[[High blood pressure]], [[edema]], and [[proteinuria]] during pregnancy
|}
<center><sup>Adapted from Hull RP, Goldsmith DJ. Nephrotic syndrome in adults. BMJ. 2008; 336:1185-9</sup></center>


==References==
==References==

Revision as of 19:49, 15 May 2018

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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. 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

Etiologic Classification

Nephrotic syndrome can be classified into primary or secondary depending on the underlying etiology.

 
 
 
Nephrotic
syndrome
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Primary
 
 
 
Secondary

Primary (Idiopathic) Nephrotic Syndrome

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:[1]

Different types of nephrotic syndromes Disease name
Podocytopathies Primary Primary minimal change disease
Primary FSGS
Secondary Infection: HIV
Drugs/toxins: NSAIDs, interferon, pamironate, lithium, vaccins, envenomation
Malignancies: hodgkin lymphoma, thymoma
Genetics: nephrin mutations, podocin
Membranous nephropathies Primary Primary membranous nephropathy
Secondary Drugs, toxins, malignancies
Membranoproliferative glomerulonephritis Secondary
  • Autoimmune disorders: SLE, aquired C3 glomerulopathy
  • Infections: HCV, endocarditis
  • Genetics
  • Malignancies
  • Thrombotic microangiopathy
Glomerular deposition diseases
  • Diabetes mellitus
  • Amyloidosis
  • Monoclonal deposition disease
  • Nodular glomeruloneohritis associated with heavy smoking
Other lesions
  • Alport syndrome
  • Fabry disease
  • Nail-patella syndrome
  • partial lipodystrophy
  • preeclampsia
  • Hereditary Nephropathies: are group of disorders that present with both the features of nephrotic and nephritic syndromes. When features of nephritic syndrome are associated with sensorineural deafness, it is called Alport’s syndrome. Other hereditary nephropathies include IgA Nephropathy, C1q Nephropathy, etc.

References

  1. Kodner C (2009). "Nephrotic syndrome in adults: diagnosis and management". Am Fam Physician. 80 (10): 1129–34. PMID 19904897.

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