• Nephrotic Syndrome:
o NS is a condition of increased glomerular permeability that allows larger molecules to pass through the membrane into the urine and then be excreted.
o Immunological Kidney disorder
o This caus
...
• Nephrotic Syndrome:
o NS is a condition of increased glomerular permeability that allows larger molecules to pass through the membrane into the urine and then be excreted.
o Immunological Kidney disorder
o This causes massive loss of protein in the urine, edema formation, and decreased plasma albumin levels.
▪ Proteinuria- severe protein loss more than 3.5 g in 24-
hour urine sample.
o Key features:
▪ Massive proteinuria >3.5g / 24hrs
▪ Hypoalbuminemia <3g/dL
▪ Edema (facial and periorbital)
▪ Lipiduria
▪ Hyperlipidemia
▪ Increased coagulation (renal vein thrombosis)
▪ Reduced kidney function (↑ BUN, ↑ Cr, ↓ GFR)
o Treatment- immunosuppressant agents (if immunity based).
▪ ACE inhibitors (to decreased protein loss in urine & ↓BP)
▪ Statins (improve blood lipid levels).
▪ Heparin (↑ coagulation / risk of thrombosis → treat
vascular effects and improve kidney function)
o Diet:
▪ If GFR is normal- dietary intake of complete proteins is
needed
▪ If GFR is decreased- dietary protein is decreased, diuretics and sodium restriction.
• Acute Kidney Injury:
o AKI is rapid reduction in kidney function resulting in a failure to maintain _uid and electrolyte balance, and acid-base balance.
▪ Can occur over a few hours or days
o Severity of AKI is based on serum creatinine increase, and decreased urine output- an increase in speci`c gravity (meaning urine is more concentrated or the patient is dehydrated).
o GFR isn’t used to measure acute injury or illness—only chronic kidney disease.
o 3 types of AKI
▪ prerenal - conditions that reduce blood _ow / oxygen to the kidney → decreased perfusion to kidneys
• azotemia- nitrogenous waste/toxin build up
o effects LOC, mood, change in personality
o related directly to reduced perfusion to the kidneys
• examples of perfusion reduction:
o blood/_uid loss- (surgery, sepsis, hypovolemic shock)
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