The term nephrotic syndrome refers to a renal disease presenting with marked proteinuria with edema. There is considerable clinical variability depending on the underlying renal disease, degree of proteinuria, and nutritional level of the patient.
Key findings:
(1) marked proteinuria, typically >= 3.0 to 3.5 g per day (or a urine protein to urine creatinine ratio > 3.0 to 3.5)
(2) edema
Some patients may be edematous with a protein excretion < 3.0 g per day, and other patients may excrete > 3.0 g per day without edema.
Associated findings:
(1) serum hypoalbuminemia and hypoproteinemia
(2) muscle wasting and protein malnutrition
(3) hyperlipidemia
(4) lipiduria
(5) pleural effusions and ascites
(6) hypercoagulability secondary to excretion of protein C, protein S and/or antithrombin III
(7) susceptibility to infections
(8) anorexia
(9) marked lethargy
(10) variable renal dysfunction
(11) variable hypertension
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