NEPHROTIC SYNDROME IN THE WORK OF A FAMILY DOCTOR

DOI: https://doi.org/10.29296/25877305-2022-02-13
Issue: 
2
Year: 
2022

Professor V. Skvortsov(1), MD; R. Bangarov(2); E. Skvortsova(1) (1)Volgograd State Medical
University (2)V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs of the Ministry
of Health of Russia, Moscow

Nephrotic syndrome is a clinical and laboratory symptom complex consisting of massive proteinuria and disorders of protein-lipid and water-salt metabolism, which are manifested by hypoproteinemia, dysproteinemia, hyperlipidemia, lipiduria, as well as anasarca edema with dropsy of serous cavities. This article is devoted to the issues of the clinic, diagnosis and treatment of nephrotic syndrome, its complications and the principles of prevention within the framework of the work of a doctor of medicine.

Keywords: 
nephrotic syndrome
proteinuria
anemia
hyperlipidemia
kidney function
edema
corticosteroids



References: 
  1. Cameron J.S., Hicks J. The origins and development of the concept of a «nephrotic syndrome». Am J Nephrol. 2002; 22: 240–7. DOI: 10.1159/000063768
  2. Llach F. Thromboembolic complications in the nephrotic syndrome. Coagulation abnormalities, renal vein thrombosis and other conditions. Postgrad Med. 1984; 76: 111–4, 116–8, 121–3. DOI: 10.1080/00325481.1984.11698782
  3. National Collaborating Centre for Chronic Conditions. Chronic kidney disease: early identification and management of adults with chronic kidney disease in primary and secondary care. Draft for consultation: full guideline published 10 March 2008. URL: www.nice.org.uk/nicemedia/pdf/CKDConsFullGuideline.pdf
  4. Jayawardene S.A., Scoble J.F., Goldsmith D.J. Nephrotic syndrome: more than just oedema. Int J Clin Pract. 2002; 56: 129–31.
  5. Ichikawa I., Rennke H.G., Hoyer J.R. et al. Role for intrarenal mechanisms in the impaired salt excretion of experimental nephrotic syndrome. J Clin Invest. 1983; 71: 91–103. DOI: 10.1172/jci110756
  6. Buerkert J., Martin D.R., Trigg D. et al. Sodium handling by deep nephrons and the terminal collecting duct in glomerulonephritis. Kidney Int. 1991; 39: 850–7. DOI: 10.1038/ki.1991.107
  7. Haas M., Meehan S.M., Karrison T.G. et al. Changing etiologies of unexplained adult nephrotic syndrome: a comparison of renal biopsy findings from 1976–1979 and 1995–1997. Am J Kidney Dis. 1997; 30 (5): 621–31. DOI: 10.1016/s0272-6386(97)90485-6
  8. Korbet S.M., Genchi R.M., Borok R.Z. et al. The racial prevalence of glomerular lesions in nephrotic adults. Am J Kidney Dis. 1996; 27 (5): 647–51. DOI: 10.1016/s0272-6386(96)90098-0
  9. Orth S.R., Ritz E. The nephrotic syndrome. N Engl J Med. 1998; 338 (17): 1202–11. DOI: 10.1056/NEJM199804233381707
  10. Ruggenenti P., Gaspari F., Perna A. et al. Cross sectional longitudinal study of spot morning urine protein:creatinine ratio, 24 hour urine protein excretion rate, glomerular filtration rate, and end stage renal failure in chronic renal disease in patients without diabetes. BMJ. 1998; 316 (7130): 504–9. DOI: 10.1136/bmj.316.7130.504
  11. Singhal R., Brimble K.S. Thromboembolic complications in the nephrotic syndrome: pathophysiology and clinical management. Thromb Res. 2006; 118 (3): 397–407. DOI: 10.1016/j.thromres.2005.03.030
  12. Parag K.B., Somers S.R., Seedat Y.K. et al. Arterial thrombosis in nephrotic syndrome. Am J Kidney Dis. 1990; 15 (2): 176–7. DOI: 10.1016/s0272-6386(12)80516-6
  13. Bellomo R., Atkins R.C. Membranous nephropathy and thromboembolism: is prophylactic anticoagulation warranted? Nephron. 1993; 63 (3): 249–54. DOI: 10.1159/000187205
  14. Llach F., Papper S., Massry S.G. The clinical spectrum of renal vein thrombosis: acute and chronic. Am J Med. 1980; 69 (6): 819–27. DOI: 10.1016/s0002-9343(80)80006-4
  15. Wagoner R.D., Stanson A.W., Holley K.E. et al. Renal vein thrombosis in idiopathic membranous glomerulopathy and nephrotic syndrome: incidence and significance. Kidney Int. 1983; 23 (2): 368–74. DOI: 10.1038/ki.1983.28
  16. Kayali F., Najjar R., Aswad F. et al. Venous thromboembolism in patients hospitalized with nephrotic syndrome. Am J Med. 2008; 121 (3): 226–30. DOI: 10.1016/j.amjmed.2007.08.042
  17. Mahmoodi B.K., Min Ki ten K., Waanders F. et al. High absolute risks and predictors of venous and arterial thromboembolic events in patients with nephrotic syndrome: results from a large retrospective cohort study. Circulation. 2008; 117 (2): 224–30. DOI: 10.1161/CIRCULATIONAHA.107.716951
  18. Sarasin F.P., Schifferli J.A. Prophylactic oral anticoagulationin nephrotic patients with idiopathic membranous nephropathy. Kidney Int. 1994; 45 (2): 578–85. DOI: 10.1038/ki.1994.75
  19. Glassock R.J. Prophylactic anticoagulation in nephrotic syndrome: a clinical conundrum. J Am Soc Nephrol. 2007; 18 (8): 2221–5. DOI: 10.1681/ASN.2006111300
  20. Kulshrestha S., Grieff M., Navaneethan S.D. Interventions for preventing thrombosis in adults and children with nephrotic syndrome (protocol). Cochrane Database Syst Rev. 2006; 2: CD006024. DOI: 10.1136/bmj.39576.709711.80
  21. Hull R.P., Goldsmith D.J.A. Nephrotic syndrome in adults. BMJ. 2008; 336 (7654): 1185–9. DOI: 10.1136/bmj.39576.709711.80
  22. Ignatova M.S., Dlin V.V. Nefroticheskij sindrom: proshloe, nastojaschee i buduschee. Rossijskij vestnik perinatologii i pediatrii. 2017; 62 (6): 29–44 [Ignatova M.S., Dlin V.V. Nephrotic syndrome: past, present and future. Rossiyskiy Vestnik Perinatologii i Pediatrii = Russian Bulletin of Perinatology and Pediatrics. 2017; 62 (6): 29–44 (in Russ.)]. DOI: 10.21508/1027-4065-2017-62-6-29-44
  23. Murkamilov I.T. i dr. Dvustoronnie kardiorenal'nye vzaimootnoshenija v organizme patsientov pri nefroticheskom sindrome. Klinicheskaja laboratornaja diagnostika. 2019; 64 (4): 196–203 [Murkamilov I.T. et al. Bilateral impact of cardiorenal relationships in the nephrotic syndrome. Klinicheskaya Laboratornaya Diagnostika = Russian Clinical Laboratory Diagnostics. 2019; 64 (4): 196–203 (in Russ.)]. DOI: 10.18821/0869-2084-2019-64-4-196-203
  24. Baranov A.A i dr. Klinicheskie rekomendatsii po okazaniju meditsinskoj pomoschi detjam s nefroticheskim sindromom. 2014; s. 5–10 [Baranov A.A et al. Klinicheskie rekomendatsii po okazaniyu meditsinskoi pomoshchi detyam s nefroticheskim sindromom. 2014; s. 5–10 (in Russ.)].
  25. Petrosjan E.K. Vrozhdennyj nefroticheskij sindrom: etiologija, diagnostika, lechenie (obzor literatury). Vestnik sovremennoj klinicheskoj meditsiny. 2013; 6 (6): 70–8 [Petrosyan E.K. Ongenital nephrotic syndrome: etiology, diagnosis, treatment (literature review). Vestnik sovremennoi klinicheskoi meditsiny. 2013; 6 (6): 70–8 (in Russ.)].