Nephrotic Syndrome and Renal Failure
Nephrotic syndrome is kidney disease with proteinuria, hypoalbuminemia, and edema. Nephrotic-range proteinuria is 3 grams per day or more. On a single spot urine collection, it is 2 g of protein per gram of urine creatinine. There are many specific causes of nephrotic syndrome. These include kidney diseases such as minimal-change nephropathy, focal glomerulosclerosis, and membranous nephropathy. Nephrotic syndrome can also result from systemic diseases that affect other organs in addition to the kidneys, such as diabetes, amyloidosis, and lupus erythematosus. Nephrotic syndrome may affect adults and children, of both sexes and of any race. It may occur in typical form, or in association with nephritic syndrome. The latter connotesglomerular inflammation, with hematuria and impaired kidney function. Nephrotic syndrome can be primary, being a disease specific to the kidneys, or it can be secondary, being a renal manifestation of a systemic general illness. In all cases, injury to glomeruli is an essential feature.
Primary causes of nephrotic syndrome include the following, in approximate order of frequency: Minimal-change nephropathy, Focal glomerulosclerosis, Membranous nephropathy ,Hereditary nephropathies . Secondary causes include the following, again in order of approximate frequency: Diabetes mellitus, Lupus erythematosus, Amyloidosis and paraproteinemias , Viral infections (eg, hepatitis B, hepatitis C, human immunodeficiency virus [ HIV] ).Nephrotic syndrome may occur in persons with sickle cell disease and evolve to renal failure. Membranous nephropathy may complicate bone marrow transplantation, in association with graft versus host disease. Kidney diseases that affect tubules and interstitium, such as interstitial nephritis, will not cause nephrotic syndrome.The above causes of nephrotic syndrome are largely those for adults, and this article will concentrate primarily on adult nephrotic syndrome. However, nephrotic syndrome in infancy and childhood is an important entity. For discussion of this topic, see the Medscape Reference article Pediatric Nephrotic Syndrome Nephrotic Syndrome. Early detection can help prevent the progression of kidney disease to kidney failure,Heart disease is the major cause of death for all people with CKD, Glomerular filtration rate (GFR) is the best estimate of kidney function, Hypertension causes CKD and CKD causes hypertension, Persistent proteinuria (protein in the urine) means CKD is present, High risk groups include those with diabetes, hypertension and family history of kidney failure, African Americans, Hispanics, Pacific Islanders, American Indians and Seniors are at increased risk. There are many specific causes of nephrotic syndrome. These include kidney diseases such as minimal-change nephropathy, focal glomerulosclerosis, and membranous nephropathy. Nephrotic syndrome can also result from systemic diseases that affect other organs in addition to the kidneys, such as diabetes, amyloidosis, and lupus erythematosus. Nephrotic syndrome may affect adults and children, of both sexes and of any race. It may occur in typical form, or in association with nephritic syndrome. Nephrotic syndrome can be primary, being a disease specific to the kidneys, or it can be secondary, being a renal manifestation of a systemic general illness. In all cases, injury to glomeruli is an essential feature.
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