Nephrotic+Syndrome

//Western Diagnosis// A. a specific sx complex that is due to a severe, prolonged increase in glomerular permeability for protein

Etiology
1. glomerular disease 2. DM 3. neoplasms 4. SLE 5. infections (HIV, HBV, EBV) 6. allergic (insect stings, poison ivy, poison oak) 7. congenital 8. drugs

Signs & Symptoms
1. frothy urine 2. proteinuria 3. anorexia, malaise 4. puffy eyelids 5. whole body edema ---anasarca ---focal edema may bring in patient initially (most common in chest & knees first) i. breathing difficulty ii. swollen knees iii. substernal chest pain from pericardial effusion 6. muscle wasting 7. abdominal pain 8. oliguria

Laboratory
1. UA ---marked proteinuria ---casts 2. dec urine Na, inc urine K 3. lipiduria 4. hypoalbuminemia, lipemia, **anemia**

Complications
1. protein malnutrition 2. brittle hair and nails 3. alopecia 4. stunted growth, kwashiorkor 5. bone demineralization 6. myopathy 7. tetany 8. peritonitis 9. infections 10. hypertension

Treatment
1. depends on histological type of renal pathology 2. elimination diet - consider protein sensitivity in cows milk