Fast Five Quiz: How Much Do You Know About Nephrotic Syndrome?

Vecihi Batuman, MD

Disclosures

July 19, 2017

The first sign of nephrotic syndrome in children is usually swelling of the face; this is followed by swelling of the entire body. Adults can present with dependent edema. Foamy urine may be a presenting feature. A thrombotic complication, such as deep venous thrombosis of the calf veins or even a pulmonary embolus, may be the first clue to nephrotic syndrome.

Additional historical features can be related to the cause of nephrotic syndrome. Thus, the recent start of a nonsteroidal anti-inflammatory drug (NSAID) suggests such drugs as the cause, and a greater-than-10-year history of diabetes with symptomatic neuropathy indicates diabetic nephropathy.

Edema is the salient feature of nephrotic syndrome and initially develops around the eyes and legs. With time, the edema becomes generalized and may be associated with an increase in weight, the development of ascites, or pleural effusions.

Hematuria and hypertension manifest in a minority of patients; this condition is sometimes referred to as "nephritic-nephrotic." Additional features on examination vary according to cause and as a result of whether renal function impairment is present. Thus, in the case of longstanding diabetes, the patient may have diabetic retinopathy, which correlates closely with diabetic nephropathy. If the kidney function is reduced, the patient may have hypertension, anemia, or both.

For more on the presentation of nephrotic syndrome, read here.

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