Nephrotic Syndrome

Kumud P Mehta
Nephrotic Syndrome - Presentation
Diagnosis of nephrotic syndrome is by simple urine examination in a child who presents with edema. The edema is generalized involving eyes, abdominal wall, genitals and ankles; ascites may be present and B.P is normal in majority of cases.

Urine examination shows presence of proteins- 3+ to 4+ by sulphosalicylic acid test or heat test or dipstick; RBC's absent or 10 - 12/HPF; no macrohematuria or persistent hematuria, no pyuria. Fatty or waxy casts may be present.

In the first attack, hospitalize the patient to come to a complete diagnosis and to plan the treatment. It is important to do the blood tests for serum proteins - Total proteins and Albumin (serum alb < 2.5g/dl); serum cholesterol ( > 200mg/dl) and BUN/S. creatinine (normal). Although steroid therapy is the backbone of therapy for nephrotic syndrome; oral Prednisolone should be started after checking for infection, hypovolemia and secondary causes.

Nephrotic Syndrome Nephrotic Syndrome 01/03/2001
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