Proteinuria >3.5 g/24 h with hypoalbuminaemia (<30 g/L) and oedema, often with hyperlipidaemia.
Causes
- • Minimal change disease (children)
- • Membranous nephropathy (anti-PLA2R)
- • FSGS
- • Diabetic nephropathy
- • Amyloidosis, lupus nephritis
Investigations
- • Urine protein:creatinine ratio, urinalysis
- • Albumin, lipids, U&E
- • Immunology: ANA, ANCA, anti-PLA2R, complement, serum free light chains, hepatitis/HIV
- • Renal biopsy in adults
Management
- • Salt restriction and loop diuretic (IV if gut oedema)
- • ACE inhibitor/ARB for proteinuria
- • Statin for dyslipidaemia
- • Immunosuppression by histology; anticoagulate if albumin <20–25 g/L with high risk
Complications
- • Venous thromboembolism including renal vein thrombosis
- • Infection (loss of immunoglobulin)
- • AKI
- • Progressive CKD
Related in WardRound
Educational — verify locally.
