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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