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4.3: Swollen Ankles, Viral URTI 2 weeks ago (resolved in 4 days), Paternal…

- - - - Protein leakage
        
        Loss of plasma oncotic pressure
        
        Imbalance of Starling forces of fluid movement favouring excess filtration
        
        Net movement of fluid into interstitium
        
        Peripheral fluid overload
        
        Oedema
        
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        Intravascular fluid depletion
        
        Hypoalbuminaemia
        
        Blood biochemistry: hypoalbuminaemia, hypoproteinaemia
        
        Can lead to nail changes (leukonychia)
        
        Increased liver albumin and lipoprotein synthesis attempting to compensate
        
        Lipid studies: hyperlipidemia (elevated TC, LDLC and TGs)
        
        Statins
        
        Proteinuria
        
        Nephrotic syndrome
        
        Light microscopy: negative Congo Red staining and no "spikes" on silver stain - findings consistent with minimal change nephropathy
        
        Minimal change glomerulopathy
        
        Pharmacological
        
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        Non-pharmacological
        
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        Electron microscopy: marked effacement of podocytes
        
        Immunofluorescence: no significant staining of IgA, IgM, C3 or C1q
        
        Serology: HBsAg and antibody negative, Hep C and HIV negative
        
        Excludes collapsing variant of FSGS
        
        Urinalysis: elevated protein (4+)
        
        ACEi/ARB
      - Impaired renal function
        
        Electrolyte imbalance
        
        Mild nausea and anorexia
        
        Blood biochemistry: elevated creatinine and urea, hypocalcaemia