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Nephrotic Syndrome — Adult Differential Diagnosis

Glomerular diseases presenting with massive proteinuria, hypoalbuminemia, and edema.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

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What is Nephrotic Syndrome — Adult Differential Diagnosis?

Nephrotic syndrome is a clinical picture caused by disruption of the glomerular filtration barrier, presenting with the tetrad of massive proteinuria (greater than 3.5 g/day), hypoalbuminemia, peripheral edema, and hyperlipidemia.

Primary causes include membranous nephropathy (most common in adults), minimal change disease, focal segmental glomerulosclerosis (FSGS), and membranoproliferative glomerulonephritis. Secondary causes include diabetic nephropathy, lupus nephritis, amyloidosis, and infections (HBV, HCV, HIV).

Thromboembolic complications (especially renal vein thrombosis), increased susceptibility to infection, and acute kidney injury are important complications.

Symptoms

Peripheral edema (prominent periorbital and lower extremity)
Frothy urine (massive proteinuria)
Weight gain (fluid retention)
Dyspnea (pleural effusion or pulmonary edema)
Abdominal distension (ascites)

Risk Factors

Diabetes mellitus (most common secondary cause)
Systemic lupus erythematosus
Amyloidosis (AL or AA)
NSAID use (minimal change disease)
Hepatitis B or C infection
Malignancy (membranous nephropathy — paraneoplastic)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • If sudden generalized edema and frothy urine appear
  • If shortness of breath and edema occur together
  • If sudden swelling and pain in a lower extremity (suspected DVT) develop
  • If kidney function tests show deterioration

Treatment Methods

01
Specific treatment is guided by the underlying cause (biopsy result directs therapy)
02
Membranous nephropathy: Rituximab or calcineurin inhibitor
03
Minimal change: Prednisone 1 mg/kg (4-16 weeks)
04
ACE inhibitor/ARB (proteinuria reduction + renoprotection)
05
Diuretics (edema management — careful use)
06
Anticoagulation (albumin less than 2.5 g/dL or thromboembolic event present)

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.