nephrotic syndrome

NEPHROTIC SYNDROME (NS) is characterized by the following:

N = Na + water retention
This occurs due to several factors, including compensatory secretion of
aldosterone in response to hypovolemia-mediated release of ADH.

E = Edema
Due to hypoproteinemia + Na, water retention. Edema is soft, pitting
and starts in the periorbital region.

P = Proteinuria >3.5gm/1.74sq. ml/24hrs

H = Hypertension + hyperlipidemia (due to increased lipoprotein
synthesis in liver , abnormal transport of circulating lipoproteins, decreased
catabolism.)

R = Renal vein thrombosis

O = "Oval fat bodies" in the urine. Lipiduria follows hyperlipidemia.
Albumin as well as lipoproteins are lost. Lipoproteins are reabsorbed by
tubular epithelial cells and they shed along with degenerated cells-
this appears as "oval fat bodies" in urine.

T = Thrombotic + thromboembolic complications owing to loss of
anticoagulant factors (eg. anti-thrombin III )

I = Infection. These patients are prone to infection, especially with
staphylococci and pneumococci. Vulnerability is due to loss of
immunoglobulins.

C = hyperCoagulable state


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