Nephrotic Syndrome

Definition

Causes

Assessment Findings and Symptoms

Medical Management

Nursing Management

Surgical Management

Heath Education

Pathophysiology

Group of signs and symptoms seen in any condition that causes glomerular damage.

Damaged glomerular basement membrane causes an increase in permeability taht allows proteins to leak out through Bowmans Capsule and Proximal tubule

Loss of proteins causes serum albumin to decrease causing a decrease in osmotic pressure

Generilsed oedema occurs

Circulating voume decreases as a result of loss of fluid in the in interstitial spaces

Production of aldesterone and angiotensin II is stimulated to bring vasoconstriction and an elevated blood pressure

History of glomerular disease

Anascaria

Proteinuria

Hypoproteinaemia

Hyperlipidemia

Hypertension

Fatigue

Malaise

Irritability

Headache

Anorexia

Diagnostic Procedures

Blood Tests

Renal Biopsy

Urinaylysis

Monitor strict intake and output

Daily urinalysis

High protein low sodium diet should be administered

Provide bed rest for severe oedema

Institute infection prevention measures

Weigh patient daily

Patient was be on position change routinely to prevent bed sores

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Severe swelling (edema), particularly around your eyes and in your ankles and feet

Foamy urine, which may be caused by excess protein in your urine

Weight gain due to excess fluid retention

Loss of appetite

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Diabetic kidney disease.
Diabetes can lead to kidney damage (diabetic nephropathy) that affects the glomeruli.

Minimal change disease.
This is the most common cause of nephrotic syndrome in children. Minimal change disease results in abnormal kidney function, but when the kidney tissue is examined under a microscope, it appears normal or nearly normal. The cause of the abnormal function typically can't be determined.

Focal segmental glomerulosclerosis.
Characterized by scattered scarring of some of the glomeruli, this condition may result from another disease or a genetic defect or occur for no known reason.

Membranous nephropathy.
This kidney disorder is the result of thickening membranes within the glomeruli. The exact cause of the thickening isn't known, but it's sometimes associated with other medical conditions, such as hepatitis B, malaria, lupus and cancer.

Systemic lupus erythematosus.
This chronic inflammatory disease can lead to serious kidney damage.

Amyloidosis.
This disorder occurs when substances called amyloid proteins accumulate in your organs. Amyloid buildup often affects the kidneys, damaging their filtering system.

Blood clot in a kidney vein. Renal vein thrombosis, which occurs when a blood clot blocks a vein connected to the kidney, can cause nephrotic syndrome.

Risk Factors

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Medical conditions that can damage your kidneys.
Certain diseases and conditions increase your risk of developing nephrotic syndrome, such as diabetes, lupus, amyloidosis and other kidney diseases.

Certain medications.
Examples of medications that can cause nephrotic syndrome include nonsteroidal anti-inflammatory drugs and drugs used to fight infections.

Certain infections.
Examples of infections that increase the risk of nephrotic syndrome include HIV, hepatitis B, hepatitis C and malaria.

Blood pressure medications
Angiotensin-converting enzyme (ACE) inhibitors reduce blood pressure and also reduce the amount of protein released in urine. Medications in this category include benazepril (Lotensin), captopril and enalapril (Vasotec)

Diuretics
Diuretic medications typically include furosemide (Lasix). Others may include spironolactone (Aldactone) and thiazides, such as hydrochlorothiazide.

Anti Coagulants
Such as heparin or warfarin may assist if you are aat risk of developing future clots

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Choose lean sources of protein

Reduce the amount of fat and cholesterol in your diet to help control your blood cholesterol levels

Eat a low-salt diet to help control the swelling (edema) you experience

Limit foods that increase blood sugar levels when taking medications that can lead to weight gain, such as steroids

Renal Biopsy