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74: Nephrotic Syndrome
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Published:May 2023
Moises Auron, MD, FAAP, FACP, SFHM, "Nephrotic Syndrome", Caring for the Hospitalized Child: A Handbook of Inpatient Pediatrics, American Academy of Pediatrics Section on Hospital Medicine, Jeffrey C. Gershel, MD, FAAP, Daniel A. Rauch, MD, FAAP, SFHM
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Nephrotic syndrome (NS) is a consequence of increased glomerular permeability with resultant heavy proteinuria. This leads to hypoalbuminemia, hyperlipidemia, and hypercoagulability. The decreased plasma oncotic pressure and sodium retention predispose the patient to edema when the fluid overload exceeds 3% to 5% of the patient’s body weight. Urinary immunoglobulin losses can increase susceptibility to severe infections (peritonitis, pneumonia, sepsis) caused by encapsulated organisms (eg, Streptococcus pneumoniae, group B streptococci).
Nephrotic syndrome can be classified according to etiology as either primary (or idiopathic) or secondary. In 85% to 90% of patients, primary NS is caused by minimal-change nephrotic syndrome (MCNS),...
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