EUH Krakow Conference: What are the causes of nephrotic syndrome?

The Bottom Line: Many underlying systemic conditions can cause nephrotic syndrome (NS), although type 2 diabetes mellitus and systemic lupus erythematosus are most common. NS may not present as a primary diagnosis, but instead as one of multiple disease manifestations, particularly in systemic lupus erythematosus.

References: Hull RP. “Nephrotic syndrome in adults.” BMJ. 2008 May 24; 336(7654):1185-1189. doi:10.1136/bmj.39576.709711.80.

Kodner C. “Diagnosis and management of nephrotic syndrome in adults.American Family Physician. 2016 Mar 15;93(6):479-485.

Summary: Key points as outlined by Hull (2008):

  • Nephrotic syndrome is a relatively rare but important manifestation of kidney disease.
  • It has serious complications and must be on the differential diagnosis for any patient presenting with new onset oedema.
  • It can be caused by a wide range of primary (idiopathic) and secondary glomerular diseases.
  • All patients should be referred to a nephrologist for further investigation, which (often) includes a renal biopsy.
  • Initial management should focus on investigating the cause, identifying complications, and managing the symptoms of the disease.

Secondary causes of NS include metabolic, immunologic, idiopathic/primary, neoplastic, medication/drug use, bacterial infection, protozoan infection, viral infection, allergic, genetic syndromes, and other. For the complete listing, see Table 1 in Kodner’s 2016 article.

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(Kodner, 2016)

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