Nephrotic Syndrome

Definition

Is a group of signs and symptoms seen in any condition that causes glomerular damage.

Pathophysiology

  • When the glomerular basement membrane is damaged,


  • There is an increase in permeability that initially allows proteins of small molecular weight to leak out,


  • Through the Bowman's capsule and proximal tubule.

  • As the condition worsens, larger proteins ( albumin) also leak out and are excreted in urine.


  • As the body continues to lose protein, serum albumin is decreased resulting in a decrease in osmotic pressure.


  • Generalized oedema occurs due to low osmotic pressure.


  • Sodium and water retention occurs, causing more oedema.


  • The disease progresses to renal failure due to persistent hypovolaemia and accelerated atherosclerosis as a result of hyperlipidaemia.

Clinical Manifestations

Anasarca

Proteinuria

Hypoproteinaemia

Hyperlipidaemia

Hypertension

Fatigue

Anorexia

Malaise

Irritability and headache

Nursing Care Plan

Diuretics may be prescribed for the management of oedema.

Strict intake and output to be measured and reported to avoid too much fluid loss.

Immunosuppressive agents may also be prescribed as well as corticosterioids.

Prevention

Limiting intake of dietary sodium, often from salt.

Fluid to reduce oedema

A diet low in saturated fat and cholesterol may also be recommended to help control hyperlipidemia.

Associated Diet

Low sodium(salt)

Lots of fruit and vegetables

Low fat (1% or skim) dairy products

Lean cuts of meat, less red meat more chicken and fish

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