NEPHROTIC SYNDROME

I.. Minimal change nephrotic syndrome
II. Nephrotic syndrome with significant lesion -

I.. Minimal change nephrotic syndrome

80 % of neph syndromes
- Clinical features
edema around eye, pitting, graduallly generalised, sustained elevation of BP
LAB findings-
heavy proteinuria, gross hematuria, hyaline casts, blodd level of igg low , igm high, protein selectivity low ratio
MANAGEMENT
- high protein diet
- no extra salts
rapid fliud losss should nt be attempted
- furosemide 1-4 mg / kg
- prednosolone 2mg/kg

management of relapse
- prednisolne 2mg/kg 2 wks
- treatment of frequent relapses
* Alternate day prednisolone 0.3- 0.7 mg/kg 10 mnths

COMPLICATIONS

1. Edema
2. infection
3. thrombotic complication
4. steroid toxicty
5. Acute renal failure

. II. Nephrotic syndrome with significant lesion -

Significant glomerular abnormalities
1. Mesangial proliferative GN
2. Focal segmental glomerulosclerosis
3. Membranoproliferative GN

Supportive care of resistent nephrotic syndrome
i.v. albumin
ACE inhibitors