Name thrombotic complications of nephrotic syndrome
Venous thromboembolism (e.g., deep vein thrombosis, pulmonary embolism)
Arterial thromboembolism
Renal vein thrombosis: thrombus formation in the renal veins or their branches
What are causes of renal vein thrombosis and it’s manifestations?
Cause: hypercoagulable state (e.g., malignancies, antiphospholipid syndrome, nephrotic syndrome)
Manifestations: flank pain, hematuria, ↑ LDH, anuria/renal failure in bilateral thrombosis
How to diagnose and treat renal vein thrombosis?
Diagnostics
CT angiography or MR venography (preferred modality in patients with renal injury or failure)
Doppler ultrasonography if no other diagnostic modality is available
Treatment
Anticoagulation
Thrombolysis or thrombectomy in selected patients
What are complications of renal vein thrombosis?
Complications: rupture of renal capsule, pulmonary embolism, kidney injury
Name atherosclerotic complications of nephrotic syndrome
Abnormal lipid metabolism in combination with a hypercoagulable state leads to an increased risk of atherosclerotic complications
Manifestation: myocardial infarction, stroke
What is another complication of nephrotic syndrome?
Chronic kidney disease: FSGS and membranous nephropathy in particular may progress to chronic kidney disease and ESRD
How is the prognosis of nephrotic syndrome?
The prognosis for minimal change disease is usually excellent.
With a wide variety of underlying diseases, the response to treatment can differ dramatically. Individuals with nephrotic syndrome often develop progressive renal failure despite treatment and go on to require dialysis.
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