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1ry ( idiopathic nephrotic syndrome )Def : clinical syndrome ch .ch by : -

- Heavy proteinuria ( > 2 gm / 24 h ) .- Hypoproteinemia .- Hypercholesterolemia .- Odema . ( mared ! generali"ed ).

Etiology : uno#n $ may be immunologic $ .

Pathogenesis : % glomerular capillary permeability & by uno#n cause or losso' ve chargedsilaprotein

*roteinuria : loss o' proteins in urine > 2 gm /d . ( selective in +, non-

selective in non +, )

Hypoproteinemia : hypoalbuminemia $ 0 2.1 gm $ 3 total protein $ 0 4.1

gm $ .

Odema :3 albumin -----> 3 plasma osmotic pressure -----> shi't o' uid 'rom intravascular to

interstitial ---> odema3 intravascular volume ------> renal ischemia -----> % aldosterone 56H -----> a !#ater

retension ---> odema Hyperlipidemia

- % hepatic synthesis o' lipids ( 3 proteins ------> 7 liver to % lipoproteins

).- 3 hepatic catabolism o' lipids ( 3 proteins ------> % lipoprotein lipase

) .

Clinical picture

8ncidence : males ( 2 9 years ) .

Generalized odema $ ephrotic odema $- tart in the morning ! disappear at the end o' the day .- tart around eyes ( periorbital puness ) ! then become generali"ed ;.; ------>

scrotum ------ > abd.- 5scites ! pleural e

7/25/2019 1 Nephrotic Syndrome

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