Monday, January 10, 2011

Nephrotic syndrome.

4 cardinal features
(1) massive proteinuria, with daily loss of 3.5 gm
(2) hypoalbuminemia, less than 3 gm/dL
(3) generalized edema
(4) hyperlipidemia and lipiduria.

There is no azotemia, hematuria, or hypertension

As fluid escapes from the vascular tree into the tissues, there is a concomitant drop in plasma volume, with diminished glomerular filtration. Compensatory secretion of aldosterone, along with the reduced GFR and reduction of secretion of natriuretic peptides, promotes retention of salt and water

hypoalbuminemia triggers increased synthesis of lipoproteins in the liver.

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