What Is Nephrosis, Nephrotic Syndrome?


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Mahwash Marcel Profile
Mahwash Marcel answered
This condition is manifested clinically by insidious onset of gross generalized edema, and by proteinuria, associated with low plasma proteins. The disease is also known as 'Lipoid Nephrosis, Subacute Nephritis).

Pure nephrosis or lipoid nephrosis starts in children below the age of five years. Nephrotic syndrome, associated with a variety of other kidney conditions is seen in older children.

Both kidneys are affected and appear very pale and swollen. The child appears to be irritable, listless and pale, with no interest in food. Edema affects face, legs and abdomen leading to weight gain. Urine output is reduced and proteinuria is present. Hematuria may occur and usually indicates a poor prognosis. Blood pressure initially is normal.

Daily testing of urine and estimation of the amount of protein lost in the urine. Frequent laboratory examination of the urine for the cells and casts, also culture for evidence of infection in the urine is required. Blood investigations needed will include a total blood picture, urea levels which are normal until the terminal stages, total plasma proteins which are low, serum cholesterol which is usually raised, and the ESR which may be elevated. Serum electrolytes should be estimated frequently. Renal biopsy may be performed to confirm the diagnosis if there is nay doubt about this.
Mahwash Marcel Profile
Mahwash Marcel answered
Nephrotic syndrome is a damage which occurs to the glomerular structure of the kidneys causing proteinuria, hypoalbuminaemia, hyperlipidemia, and edema. It usually follows a previous infection. It may be classified according to the duration and kidney damage (minimal change nephrotic syndrome, secondary nephrotic syndrome, or congenital nephrotic syndrome). It is more commonly seen in children 2 – 3 years of age. This prognosis is good but the child may experience a relapse.

The common symptoms are edema of face, abdomen, extremities; increase in weight, perineal edema, diarrhea, scanty dark coloured urine, lethargy, fatigue, hematuria, azotemia, proteinuria, hypovolemia; may experience respiratory difficulty if ascites is extreme.

It is diagnosed by the presence of proteinuria, hematuria, elevated BUN, decreased creatinine clearances. Renal biopsy reveals disease process.

Administer antibiotics specific to organism; long term corticosteroid therapy, immunosuppressant therapy, diuretics, and cytoxan pulses (small doses of cytoxan given quickly with hydration pre and post administration) may be utilized.

Hospitalization may be necessary initially, promote rest, and provide diet with minimal salt.

Unnecessary unless renal biopsy (punch or wedge resection) is indicated.

Potential complications
The potential complications are: Relapse, infections, skin break down, social isolation (if frequent relapses occur), chronic renal disease, shock (from electrolyte imbalance), and death if untreated.

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