Nephrotic Syndrome PPT

Nephrotic Syndrome PPT

1. NEPHROTIC SYNDROME PRESENTED BY:- PROF. VIJAYREDDY VANDALI M. SC. (NSG), PGDHA, DEPARTMENT OF MEDICAL–SURGICAL NURSING . INDIA

2. DEFINITION The term Nephrotic syndrome describes a clinical course that can be associated with a number of disease conditions. Nephrotic syndrome is not a single diseases entirely but a constellation of symptoms including albuminuria, hypoalbuminuria, edema, hyperlipidemia, and lipduria. This syndrome causes damage to the glomeruli with resultant Proteinuria.

3. KIDNEYs

4. GLOMERULUS

5. ETIOLOGY Primary Glomeruli Disease Membranous proliferative glomerulonephritis. Primary Nephrotic syndrome. Focal glomerulonephritis. Inherited Nephrotic syndrome.

6. CONTD….. External causes 1) Multisystem disease Systematic lupus erythematous Diabetes Mellitus. Sickle cell anemia. Amyloidosis

7. 2)Infections Bacterial (streptococcal, syphilis) Viral (herpes zoster, HIV, hepatitis) Protozoa (malaria) 3) Neoplasm Hodgkin’s disease Solid tumors of lung, colon, stomach and breast. Leukemia.

8. 4) Circulatory problems Severe congestive heart failure Chronic constructive Pericarditis 5) Allergic reaction Insect bites, bee sting and pollen Drugs (penicillamine, non steroidal anti inflammatory drugs)

9. Clinical manifestation It is characterized by Proteinuria (>3.5g/day), hypoalbuminuria, hyperlipidemia and edema which is generalized & also known as anasarca or dropsy. The edema begins in the face. Lipduria (lipids in urine) can also occur, but is not essential for the diagnosis of Nephrotic syndrome.

10. HYPERLIPIDEMIA

11. EDEMA

12. CONTD… Anemia Dyspnea Some patients may notice foamy or frothy urine

13. Complications Venous thrombosis Infection Acute renal failure Pulmonary edema Growth retardation Hypovolamia

14. TREATMENT Monitoring and maintaining hypovolemia (the correct amount of fluid in the body): Monitoring urine output, BP regularly. Fluid restrict to 1 L. Diuretics (IV furosemide).

15. CONTD… Monitoring kidney function: Do EUCs daily and calculating GFR. Treat hyperlipidemia to prevent further atherosclerosis. Prophylactic anticoagulation may be appropriate in some circumstances.

16. CONTD… Specific treatment of underlying cause Immunosuppressant for the glomerulonephritides (corticosteroids, cyclosporine). Standard regime for first episode: prednisolone-60 mg/m 2 /day in 3 divided doses for 4 weeks followed by 40 mg/m 2 /day in a single dose on every alternate day for 4 weeks.

17. CONTD… Relapses by prednisolone 2 mg/kg/day till urine becomes negative for protein. Then, 1.5 mg/kg/day for 4 weeks. Frequent relapses treated by: cyclophosphamide or nitrogen mustard or cyclosporine or levamisole. Achieving better blood glucose level control if the patient is diabetic.

18. THANK YOU