Steroid-sensitive nephrotic syndrome

Not to be confused with Nephritic syndrome.

Nephrotic syndrome
Nephrotic eyes.JPG
Microscopic image of diabetic glomerulosclerosis, the main cause of nephrotic syndrome in adults.
Specialty	Nephrology
Symptoms	Swelling, weight gain, feeling tired, foamy urine
Complications	Blood clots, infections, high blood pressure
Causes	Focal segmental glomerulosclerosis, membranous nephropathy, minimal change disease, diabetes, lupus
Diagnosis	Urine testing, kidney biopsy
Differential diagnosis	Nephritic syndrome, cirrhosis, severe malnutrition
Treatment	Directed at underlying cause
Frequency	5 per 100,000 per year

Steroid-sensitive nephrotic syndrome refers to nephrotic syndrome, which occurs primarily in the pediatric population. It is characterized by the normalization of proteinuria with the administration of corticosteroids. This contrasts with steroid-resistant nephrotic syndrome, where proteinuria persists despite treatment.

Overview

Nephrotic syndrome is a clinical condition that occurs due to damage to the glomeruli in the kidneys. This condition leads to significant loss of protein in the urine, resulting in hypoalbuminemia, edema, and other systemic complications. It can occur in both children and adults, with varying causes depending on the age group.

Pathophysiology

Nephrotic syndrome is primarily caused by increased permeability of the glomerular filtration barrier. The underlying causes include:

• Primary glomerular diseases: Focal segmental glomerulosclerosis (FSGS), membranous nephropathy, minimal change disease (MCD).
• Secondary causes: Diabetes mellitus, systemic lupus erythematosus (SLE), infections, and certain drugs.

Clinical Features

• Symptoms:
• Swelling (edema), especially around the eyes and ankles.
• Weight gain.
• Foamy urine due to proteinuria.
• Fatigue.
• Complications:
• Increased risk of blood clots.
• Predisposition to infections.
• Potential development of high blood pressure.

Diagnosis

The diagnosis of nephrotic syndrome involves:

• Urinalysis: To detect significant proteinuria.
• Blood tests: To assess albumin levels, lipid profile, and kidney function.
• Kidney biopsy: In selected cases to determine the underlying pathology.

Management

Treatment is directed at the underlying cause:

• Corticosteroids: Often effective in children with minimal change disease.
• Management of complications: Includes anticoagulants for thrombosis, antibiotics for infections, and diuretics for severe edema.

Epidemiology

The annual incidence of nephrotic syndrome is approximately 5 per 100,000 people.

Also see

• Nephritic syndrome