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