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A busy haematuria clinic
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Diabetes mellitus, amyloidosis, systemic vasculitides, Henoch-Schonlein purpura, drugs and allergies are all causes of the nephrotic syndrome. In addition, all types of glomerulonephritis can present as the nephrotic syndrome.
Diabetic Nephropathy
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
The primary symptoms of nephrotic syndrome include anorexia, frothy urine because of high protein concentrations, and malaise. Fluid retention may result in abdominal pain, arthralgia, and dyspnea. The abdominal pain may be due to ascites, or in children, due to mesenteric edema. Arthralgia is due to hydroarthrosis, an accumulation of watery fluid in joint cavities. Dyspnea is caused by laryngeal edema or pleural effusion. Edema can obscure signs of muscle wasting, and also cause Muehrcke lines in the fingernail beds, which appear as parallel white-colored markings. Additional signs and symptoms may exist, due to complications the syndrome. These include infections such as cellulitis, and spontaneous bacterial peritonitis. There can also be anemia, changes in thyroid function test results, hypercoagulability and thromboembolism (most often being renal vein thrombosis and pulmonary embolism, in as many as 40% of adults and 5% of children), pediatric protein undernutrition (sometimes causing alopecia, brittle nails and hair, and growth stunting), and dyslipidemia.
Kidney Disease
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Amy J. Litterini, Christopher M. Wilson
Chronic kidney disease (CKD) results from conditions which either damage or reduce the function of one or both kidneys. Nephritis refers to inflammation of the kidneys, while nephrosis refers to non-inflammatory kidney disease associated with damage or degeneration. Nephrotic syndrome refers to small vessel damage within the kidneys causing excess protein to be released into the urine.
Cost-effectiveness of the adjuvanted quadrivalent influenza vaccine in the elderly Belgian population
Published in Expert Review of Vaccines, 2023
Sophie Marbaix, Nicolas Dauby, Joaquin Mould-Quevedo
Respiratory diagnoses other than influenza are the most frequent complications and include bronchitis, pneumonia or any URTI, and acute exacerbation of COPD. Myocarditis, MI, renal or CNS complications, and stroke are the nonrespiratory complications associated with influenza infection. Renal complications refer to acute renal failure, glomerulonephritis, and nephrotic syndrome. CNS complications include meningitis, psychosis, epilepsy and Guillain-Barré syndrome. The probabilities of developing these complications were mainly derived from an observational study conducted in the United Kingdom [4] and adapted for a previous cost-effectiveness analysis [20]. The nature of the complications and the risk of hospitalization due to complications were validated by Belgian experts. All nonrespiratory complications were assumed to require hospitalization. Bronchitis and URTIs were mainly managed in outpatient settings. The risk of hospitalization due to pneumonia was derived from a previous Belgian cost-effectiveness analysis [38]. A similar risk of hospitalization was assumed in the case of COPD exacerbations based on the number of hospitalizations due to influenza in combination with pneumonia and COPD diagnoses [3].
Expression of the IL-2R in Human Podocytes and the Effect of Activation on Autophagy and Apoptosis
Published in Fetal and Pediatric Pathology, 2021
Tyrus Stewart, Arnold Zea, Diego Aviles
Nephrotic syndrome (NS) is one of the most common glomerular disease of childhood, with an annual incidence of between 1 and 17 per 100,000 children, depending on the population [7]. Nephrotic syndrome is characterized by massive proteinuria, hypoalbuminemia, and edema. In many cases the cause is unknown, but the pathogenesis is thought to involve immune dysregulation, systemic circulating factors, or inherited structural abnormalities of the podocyte [8]. Serum from patients with idiopathic nephrotic syndrome (INS) during relapse, have increased levels of the cytokine IL-2 [9, 10]. We have previously reported increased IL-2 mRNA levels in T-lymphocytes of patients with INS in relapse [11]. Increasing evidence suggests that IL-2 is associated with proteinuria [12–16]. In an experimental model of reduced kidney function, uninephrectomized rats had increased IL-2 and IL-2R expression in the kidney and increased proteinuria [13]. Rosenstein et. al, demonstrated that IL-2 infusion in rats results in proteinuria [15]. Furthermore, the use of high dose IL-2 for cancer treatment has been shown to induce proteinuria [12, 14]. We have previously described the expression of the IL-2R in a murine podocyte cell line [16]. Further, we found that in vitro stimulation with IL-2 resulted in podocyte injury [16]. Here we describe the expression of the IL-2R in a human podocyte cell line and the effect of IL-2 stimulation on markers of apoptosis and autophagy.
Early diagnosis and successful treatment of cytomegalovirus peritonitis in children with primary nephrotic syndrome: case series and literature review
Published in Renal Failure, 2020
Haiting Lin, Lizhi Chen, Songyang Wen, Zhihui Yue, Ying Mo, Xiaoyun Jiang, Liuyi Huang
Nephrotic syndrome refers to excessive proteinuria, with associated hypoalbuminemia, edema, and hyperlipidemia. The infectious complications, especially primary peritonitis, are well-known alarming situation in children with NS. Studies have shown incidence of peritonitis in childhood NS ranging from 2.6% to 26.0% [7–10]. Patients with NS have a defective immune response due to increased urinary losses of complement factor B, low IgG levels, inadequate opsonization and impaired T-cell function [11–13]. Ascites formation secondary to hypoalbuminemia also contributes to the development of peritonitis. Furthermore, treatment with immunosuppressive agents further predisposes to an increased risk of infection [2]. The most common pathogens causing spontaneous peritonitis is bacteria and viruses are rarely reported.