Nephrotic syndrome causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mehrian Jafarizade, M.D [2], Yazan Daaboul, Serge Korjian

Overview

Nephrotic syndrome can occur primarily or due to systemic diseases. The most common cause of nephrotic syndrome in children is minimal change disease. The most common primary causes in adults are focal segmental glomerulosclerosis (FSGS), minimal change disease, and membranous nephropathy. Approximately 30 percent of adults have secondary nephrotic syndrome due to diabetes mellitus, SLE, or amyloidosis. The most common cause of secondary nephrotic syndrome in adults is diabetes mellitus.

Causes

Nephrotic syndrome can occur primarily or due to systemic diseases. The most common cause of nephrotic syndrome in children is minimal change disease. The most common primary causes in adults are focal segmental glomerulosclerosis (FSGS), minimal change disease, and membranous nephropathy. Approximately 30 percent of adults have secondary nephrotic syndrome due to diabetes mellitus, SLE, or amyloidosis.[1][2][3][4][5][6][7]

Primary Causes

Primary renal disorders, such as primary glomerulonephritides, may cause primary nephrotic syndrome. Differentiation between different types of glomerular diseases is often made by clinical suspicion and by renal biopsy, which includes light microscopy, immunofluorescence, and ideally electron microscopy.

Secondary Causes

Secondary causes of renal disorders cause secondary nephrotic syndrome. The most common cause of secondary nephrotic syndrome in adults is diabetes mellitus. Shown below is a table of the causes of nephrotic syndrome by age group.[8]

Common Causes of Nephrotic Syndrome by Age

Age (Years) Cause of Nephrotic Syndrome
< 15
15-40
>40

Adapted from Rose BD. Pathophysiology of renal diseases, ed. 2. New York, McGraw-Hill, 1987,p. 167

Drug Induced

Causes by Organ System

Cardiovascular Endocarditis
Chemical/Poisoning Gold, mercury
Dental No underlying causes
Dermatologic Dermatomyositis,
Drug Side Effect Agalsidase beta, Certolizumab pegol, Coagulation factor IX, Olsalazine, Sodium aurothiomalate, Trimethadione, Ziv-aflibercept , Interferon, lithium, NSAID, Penicillamine, Probenecid, Sorafenib
Ear Nose Throat No underlying causes
Endocrine Diabetes mellitus, thyroid disease
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic Castleman's disease, sickle cell anemia
Iatrogenic No underlying causes
Infectious Disease HIV, Infectious mononucleosis, malaria, streptococcal infection, syphilis, toxoplasmosis, viral hepatitis
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic Preeclampsia
Oncologic Leukemia, lymphoma, multiple myeloma
Ophthalmologic No underlying causes
Overdose/Toxicity Heroin
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte Amyloidosis, chronic interstitial nephritis, fabry's disease, Goodpasture's syndrome, oligomeganephronia, orthostatic proteinuria, renal vein thrombosis
Rheumatology/Immunology/Allergy Bee sting, food allergens, Graft vs. host disease, Henoch-Schonlein purpura, Kimura's disease, mixed connective tissue disease, polyarteritis nodosa, rheumatoid arthritis, sarcoidosis, Sjogren's syndrome, systemic lupus erythematosus, vasculitis
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous Lipoatrophy, obesity

Causes of Secondary Causes in Alphabetical Order

References

  1. Rivera F, López-Gómez JM, Pérez-García R (September 2004). "Clinicopathologic correlations of renal pathology in Spain". Kidney Int. 66 (3): 898–904. doi:10.1111/j.1523-1755.2004.00833.x. PMID 15327378.
  2. Haas M, Meehan SM, Karrison TG, Spargo BH (November 1997). "Changing etiologies of unexplained adult nephrotic syndrome: a comparison of renal biopsy findings from 1976-1979 and 1995-1997". Am. J. Kidney Dis. 30 (5): 621–31. PMID 9370176.
  3. Simon P, Ramee MP, Boulahrouz R, Stanescu C, Charasse C, Ang KS, Leonetti F, Cam G, Laruelle E, Autuly V, Rioux N (September 2004). "Epidemiologic data of primary glomerular diseases in western France". Kidney Int. 66 (3): 905–8. doi:10.1111/j.1523-1755.2004.00834.x. PMID 15327379.
  4. Braden GL, Mulhern JG, O'Shea MH, Nash SV, Ucci AA, Germain MJ (May 2000). "Changing incidence of glomerular diseases in adults". Am. J. Kidney Dis. 35 (5): 878–83. PMID 10793022.
  5. Malafronte P, Mastroianni-Kirsztajn G, Betônico GN, Romão JE, Alves MA, Carvalho MF, Viera Neto OM, Cadaval RA, Bérgamo RR, Woronik V, Sens YA, Marrocos MS, Barros RT (November 2006). "Paulista Registry of glomerulonephritis: 5-year data report". Nephrol. Dial. Transplant. 21 (11): 3098–105. doi:10.1093/ndt/gfl237. PMID 16968733.
  6. Bahiense-Oliveira M, Saldanha LB, Mota EL, Penna DO, Barros RT, Romão-Junior JE (February 2004). "Primary glomerular diseases in Brazil (1979-1999): is the frequency of focal and segmental glomerulosclerosis increasing?". Clin. Nephrol. 61 (2): 90–7. PMID 14989627.
  7. Gesualdo L, Di Palma AM, Morrone LF, Strippoli GF, Schena FP (September 2004). "The Italian experience of the national registry of renal biopsies". Kidney Int. 66 (3): 890–4. doi:10.1111/j.1523-1755.2004.00831.x. PMID 15327376.
  8. Eddy AA, Symons JM (2003). "Nephrotic syndrome in childhood". Lancet. 362 (9384): 629–39. doi:10.1016/S0140-6736(03)14184-0. PMID 12944064.

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