Nephrotic Syndrome
This life-threatening complication of nephrotic syndrome is caused by urinary loss of antithrombin III, classically associated with membranous nephropathy, and commonly presents with flank pain and hematuria.
What is renal vein thrombosis?
+ BONUS: When a thrombus from nephrotic hypercoagulability embolizes to the lungs, it can cause a PE.
This complication results from reduced GFR and presents with oliguria and elevated serum creatinine.
What is acute kidney injury?
This disease presents with episodic hematuria shortly after URI or GI infection and is caused by IgA deposition in the mesangium. It is associated with _______ syndrome.
What are IgA nephropathy (Berger disease) and Nephritic syndrome?
Loss of these two types of proteins in the urine predisposes nephrotic patients to infections with encapsulated organisms.
What are immunoglobulins (especially IgG) and complement proteins (e.g., C3)?
This life-threatening complication of nephritic syndrome results from volume overload and may present with dyspnea and crackles.
What is pulmonary edema?
A child with sudden-onset edema and proteinuria has normal glomeruli on light microscopy but diffuse podocyte foot process effacement on EM. They have _______ syndrome.
What are minimal change disease and Nephrotic syndrome?
Loss of this iron-transport protein in urine can lead to microcytic anemia in nephrotic syndrome.
What is transferrin?
This severe complication involves crescent formation in Bowman space and can rapidly progress to renal failure within weeks.
What is rapidly progressive glomerulonephritis (RPGN)?
Pathophys: A rupture in the glomerular basement membrane causes inflammatory mediators (fibrin, monocytes, T cells) to enter Bowman’s space, prompting proliferation of parietal epithelial cells. As fibroblasts lay down collagen, the lesion becomes a scar, leading to irreversible kidney damage.
This systemic disease causes _______ syndrome due to the deposition of misfolded proteins in the glomerulus, leading to a positive Congo red stain.
What are amyloidosis and Nephrotic syndrome?
Loss of this protein in the urine leads to Vitamin D deficiency, secondary hyperparathyroidism, and increased fracture risk.
What is vitamin D–binding protein?
Vitamin D travels through the bloodstream bound to a carrier protein called Vitamin D-Binding Protein (VDBP). Due to glomerular damage in nephrotic syndrome, this protein is lost in the urine, removing the vitamin D bound to it.
This acid-base disturbance develops due to decreased acid excretion in nephritic syndrome.
What is metabolic acidosis?
Nephritic Syndrome is an inflammatory process. Inflammation directly damages the glomeruli, causing a sharp drop in GFR, leading to reduced urine output (oliguria) and waste product retention (azotemia/AKI). When the GFR is significantly reduced, the kidneys cannot adequately filter waste or excrete acid (H+), leading to metabolic acidosis.
Nephrotic Syndrome is a non-inflammatory process (damage to podocytes) that results in massive protein leakage (>3.5g/day) without necessarily ruining the glomerular filtration of metabolic wastes in the early stages.
This rapidly progressive condition is caused by antibodies against the glomerular basement membrane and may also cause pulmonary hemorrhage. It is associated with _______ syndrome.
What are Goodpasture syndrome (anti-GBM disease) and Nephritic syndrome?
This long-term complication is particularly associated with FSGS and sometimes membranous nephropathy.
What is chronic kidney disease (CKD)/ESRD?
This neurologic complication of severe hypertension in nephritic syndrome presents with headache, confusion, and visual changes.
What is hypertensive encephalopathy?
A patient with hematuria, hearing loss, and ocular abnormalities has a mutation in type IV collagen affecting the GBM. They have _______ syndrome.
What are Alport syndrome and Nephritic syndrome?