Remember the clinical features in nephrotic syndrome by understanding the pathophysiology behind these findings.
Na + water retention
This occurs due to several factors, including compensatory secretion of aldosterone in response to hypovolemia mediated release of ADH.
Edema
Due to hypoproteinemia + Na, water retention. Edema is soft, pitting and starts in the periorbital region.
Proteinuria >3.5gm/1.74sq. ml/24hrs
Hypertension + Hyperlipidemia
due to increased lipoprotein synthesis in liver, abnormal transport of circulating lipoproteins, decreased catabolism.
Renal vein thrombosis
“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.
Thrombotic + Thromboembolic complications owing to loss of anticoagulant factors (eg. antithrombin III)
Infection
These patients are prone to infection, especially with staphylococci and pneumococci.Vulnerability is due to loss of immunoglobulins.
hyperCoagulable state
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