Presentation on theme: "Nephrotic Syndrome (NS) Definition NS is an accumulation of symptoms and signs and is characterized by proteinuria, hypoproteinemia, edema, and hyperlipidemia."— Presentation transcript:
Definition NS is an accumulation of symptoms and signs and is characterized by proteinuria, hypoproteinemia, edema, and hyperlipidemia.
The vast majority patients (90% of cases) with NS of childhood are primary. In children under age 5 years the disease usually takes the form of idiopathic (primary) NS of childhood (nil disease, lipoid Nephrosis).
Conditions Of Attack Second only to acute nephri- tis. Incidence age: At all ages, but most commonly between 2~5 years of age.
Type 1.Clinical type Simple NS ; Nephritic NS 2.Response to steroid therapy (P 331 )
The initial response to cortico- steroids is a guide to prognosis. (1) Total effect (2) Partial effect (3) Non-effect
3. Pathologic type (P 328 ) Minimal change disease, MCD: 80% of patients.
Pathogenesis The primary disorder is an increase in glomerular permea- bility to plasma proteins. ▲ Foot processes of the visceral epithelium of the GBM.
1.The construction of the glomerular basement memb- rane has changed. 2.The loss of the negative charges on the GBM.
◆ The underlying pathoge- nesis is unknown, but evidence strongly supports the impor- tance of immune mechanisms (P 328 ).
Pathophysiology 1.Proteinuria: Fundamental and highly important change of pathophysiology.