BMJ  2008;336:1185-1189 (24 May), doi:10.1136/bmj.39576.709711.80

Clinical Review

Nephrotic syndrome in adults

Richard P Hull, specialist registrar, David J A Goldsmith, consultant nephrologist

1 Guy’s Hospital Renal Unit, London SE1 9RT

Correspondence to: DJA Goldsmith david.goldsmith@gstt.nhs.uk

The first 150 words of the full text of this article appear below.

The nephrotic syndrome is one of the best known presentations of adult or paediatric kidney disease. The term describes the association of (heavy) proteinuria with peripheral oedema, hypoalbuminaemia, and hypercholesterolaemia (box 1). Protein in the urine ("coagulable urine") was first described in 1821, 15 years before Richard Bright’s celebrated series of descriptions of "albuminous urine."1


Proteinuria greater than 3-3.5 g/24 hour or spot urine protein:creatinine ratio of >300-350 mg/mmol
Serum albumin <25 g/l
Clinical evidence of peripheral oedema
Severe hyperlipidaemia (total cholesterol often >10 mmol/l) is often present


Nephrotic syndrome has an incidence of three new cases per 100 000 each year in adults.2 It is a relatively rare way for kidney disease to manifest compared with reduced kidney function or microalbuminuria as a complication of systemic diseases, such as diabetes and raised blood pressure.3


Nephrotic syndrome is a relatively rare but important manifestation of kidney disease
It has serious . . . [Full text of this article]


Other diseases
Cancer
Drugs
Infections
Congenital causes
Oedema
Low albumin
Breathlessness
Breathlessness with chest pain
Dyslipidaemia
Other
Resources for healthcare professionals
Resources for patients

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