5 Nephrotic_syndrome............ .pptx

Nephrotic_syndrome

1. Jones 2012 Nephrotic syndrome 10/14/2017 11:10 PM 1 jones mhango

2. Aims Be aware of nephrotic syndrome How to diagnose Basic treatment 10/14/2017 11:10 PM 2 jones mhango

3. What is nephrotic syndrome? 10/14/2017 11:10 PM 3 jones mhango

4. Nephrotic syndrome Damage of glomerulus Protein leaks through Protein lost in urine 10/14/2017 11:10 PM 4 jones mhango

5. Nephrotic syndrome findings Hypoalbuminaemia Proteinuria Oedema Usually high lipids 10/14/2017 11:10 PM 5 jones mhango

6. What do they look like? 10/14/2017 11:10 PM 6 jones mhango

7. Signs and symptoms Oedema Ascites (accumulation of fluid in the peritoneal cavity) Pleural effusions Hepatomegaly Puffy face hypertension 10/14/2017 11:10 PM 7 jones mhango

8. Further signs Xanthelesma ( deposit of cholesterol on the eyelid) Cholestrol deposits 10/14/2017 11:10 PM 8 jones mhango

9. Xanthomata 10/14/2017 11:10 PM 9 jones mhango

10. What would be the differential diagnosis? Causes of gen oedema 10/14/2017 11:10 PM 10 jones mhango

11. Oedema differential Heart failure Liver failure Kidney failure Nephrotic syndrome 10/14/2017 11:10 PM 11 jones mhango

12. Causes of nephrotic syndrome Idiopathic Glomerulonephritis (to be discussed later) Diabetes Post infection (strep, HIV, Hep B, Malaria) 10/14/2017 11:10 PM 12 jones mhango

13. Problems Increased infections Thromboembolism ( blockage of an artery due to fats, air sac ,fluids ) Hyperlipidaemia Acute renal failure 10/14/2017 11:10 PM 13 jones mhango

14. How will we diagnose nephrotic syndrome? 10/14/2017 11:10 PM 14 jones mhango

15. Diagnosis Urine protein on dipstick Albumin/ protein levels Biopsy would be ideal 10/14/2017 11:10 PM 15 jones mhango

16. Look for underlying cause Imaging CXR, Renal USS In some cases renal function normal 10/14/2017 11:10 PM 16 jones mhango

17. Treatment Steroids- 40-50 mg prednisolone OD Diuretics – frusemide 40-80 mg BD Treat hypertension as protocol Treat infections Best managed in hospital 10/14/2017 11:10 PM 17 jones mhango

18. Prognosis- minimal change Often relapse Can take 8-24 /52 for steroids to work Rapid withdraw of steroid ↑relapse Cyclophosphamide if relapse 10/14/2017 11:10 PM 18 jones mhango

19. Other causes Glomerulonephritis slower to respond 10/14/2017 11:10 PM 19 jones mhango

20. Good indicators for prognosis Young age No renal damage No hypertension Good initial response to steroid 10/14/2017 11:10 PM 20 jones mhango

21. Thank you Questions? 10/14/2017 11:10 PM 21 jones mhango