Nephrotic syndrome is characterised by -a) Proteinuriab) Hyperlipidemiac) Oedemad) Haematuriae) Lipiduria

Pathophysiology of nephrotic syndrome Proteinuria The most important feature of nephrotic syndrome is massive proteinuria (>3.5 gm/day) Proteinuria results from altered permeability of glomerular filtration barrier for protein. The largest proportion of protein lost in the urine is albumin but globulins are also excreted in some diseases. The ratio of low to high molecular weight proteins in urine in various cases of syndrome is a manifestation of the selectivity of proteinuria. A highly selective proteinuria consists mostly of low molecular weight proteins, i.e. albumin & transferrin, where as a poorly selective proteinuria consists of higher molecular weight globulin in addition to albumin. Edema Proteinuria leads to hypoalbuminemia that results in decreased colloid osmotic pressure edema. Hyperlipidemia Increased synthesis of lipoproteins by liver. Decreased catabolism of lipids. There is increased cholesterol, triglycerides VLDL, and LDL. Lipiduria Hyperlipidemia results in lipiduria due to excessive leakiness of glomerular filtration barrier.