Nephrotic Syndrome

(redirected from Nephrotic syndromes)
Also found in: Dictionary, Thesaurus, Medical.
Related to Nephrotic syndromes: nephritic syndrome

nephrotic syndrome

[nə′fräd·ik ′sin‚drōm]
(medicine)
A complex of symptoms, including proteinuria, hyperalbuminemia, and hyperlipemia, resulting from damage to the basement membrane of glomeruli.

Nephrotic Syndrome

 

the modern designation for a group of kidney diseases whose symptoms include considerable proteinuria (the loss of more than 5 g of protein per day through the urine), disturbances in the protein-fat metabolism, and—in most cases—edema. The term “nephrotic syndrome” replaced the obsolete term “nephrosis” in the 1950’s and was formally introduced in 1968 into the nomenclature of diseases.

The nephrotic syndrome is usually a consequence of nephritis, amyloidosis, nephropathy during pregnancy, pyelonephritis, tumors, lesions of the kidneys as a result of collagenosis, myeloma, diabetes mellitus, tuberculosis, syphilis, or malaria. In certain instances, especially in children, it is impossible to find the cause of the nephrotic syndrome. In these cases, the syndrome is called a primary, or idiopathic, nephrotic syndrome. The most widespread of the theories explaining the pathogenesis of the nephrotic syndrome is the immunological theory: antibodies directed against the kidneys are formed, eliciting an increase in the permeability of the glomerular filter of the kidneys. Such an increase in permeability leads to proteinuria.

The most important clinical manifestation of the nephrotic syndrome is edema, which occurs first on the face and then spreads to the entire subcutaneous tissue. Because of the loss of protein through the urine and because of metabolic disturbances, the concentration of protein in the blood decreases. This decrease is greatest in the finely dispersed fractions of the blood. Other symptoms include muscular weakness and a lowered resistance to infection. The fat content of the blood increases sharply.

Treatment of the nephrotic syndrome involves bed rest, a low-salt and low-water diet with an adequate protein content, anabolic hormones, diuretics, corticosteroids, 4-aminoquino-lines, immunosuppressants, and indole derivatives. Treatment at a climatic resort, such as Bairam-Ali, is recommended when the syndrome is not aggravated by renal insufficiency and persistent hypertension. Lola in the Kalmyk ASSR and the Southern Crimean Shore are both recommended for the more moderate cases of the nephrotic syndrome.

REFERENCE

Osnovy nefrologii, vol. 1. Edited by E. M. Tareev. Moscow, 1972.

N. R. PALEEV

References in periodicals archive ?
Nozu et al., "Rituximab for childhood-onset, complicated, frequently relapsing nephrotic syndrome or steroid-dependent nephrotic syndrome: a multicentre, doubleblind, randomised, placebo-controlled trial," The Lancet, vol.
Jordan et al., "Efficacy and safety of treatment with rituximab for difficult steroid-resistant and--dependent nephrotic syndrome: multicentric report," Clinical Journal of the American Society of Nephrology, vol.
Nozu et al., "Single dose of rituximab for refractory steroid-dependent nephrotic syndrome in children," Pediatric Nephrology, vol.
HP Acthar gel (ACTH), as described above, has been used in different underlying causes of nephrotic syndrome including MCD [57].
tested whether pioglitazone would enhance the efficacy of glucocorticoids in reducing proteinuria in puromycin aminoglycoside- (PAN-) induced nephrotic syndrome in rats [61].
It has recently been shown to be effective in rituximab-resistant nephrotic patients in case reports and small case series (mostly children) with nephrotic syndrome [32, 41, 88, 89].
Saquinavir, an HIV protease inhibitor with proteasome inhibiting activity, has been tested in a pilot study and in case reports in patients with a long history of nephrotic syndrome despite immunosuppressive therapy [110, 111].
However, even though the incidence of primary causes of nephrotic syndrome is low, the lack of larger RCTs in this field is striking [112].
Initially, the kidneys of rats with PAN-induced nephrotic syndrome were examined histopathologically.
Experiments were conducted to determine whether ENaC subunit expression is altered in rats with PAN-induced nephrotic syndrome. The protein levels of the [alpha]-ENaC and [beta]-ENaC subunits significantly increased in the PAN group.
SMIT mRNA level was also significantly affected in rats with PAN-induced nephrotic syndrome. Moreover, MR mRNA expression markedly increased in the renal medulla in the PAN group, whereas in the WPC group this was decreased.
The results demonstrate that PAN-induced nephrotic syndrome is associated with decreased urine concentration, manifested by an increased urine output, decreased urine osmolality, and a marked upregulation of collecting duct water channels (AQP2) [31].