MEDICOMEDICS
Get started

Nephrology

Nephrotic Syndrome

Glomerular disease with proteinuria >3.5 g/day, hypoalbuminaemia, oedema and hyperlipidaemia; loss of podocyte barrier function.

Last reviewed 31 May 2026 - MedicoMedics editorial team

Glomerulonephritis with proteinuria

Pathophysiology

Podocyte injury from minimal change (children), FSGS, membranous, diabetic or amyloid; PLA2R antibodies in ~70% primary membranous.

Sources: KDIGO Glomerular Diseases 2021; NEJM PLA2R 2009;361:11

Presentation

Frothy urine, periorbital and dependent oedema, weight gain, hyperlipidaemia, hypercoagulability with renal vein thrombosis risk.

Diagnosis

24-h urine protein or spot UPCR >3.5, hypoalbuminaemia <3 g/dL, serologies (ANA, hepatitis, PLA2R), kidney biopsy in adults.

Management

ACEi/ARB reduce proteinuria; sodium restriction; loop diuretic for oedema; statin; anticoagulation if albumin <2.5 with membranous. Specific therapy: steroids for minimal change; rituximab or tacrolimus for membranous.

Sample USMLE-style MCQs

Try 5 questions on this topic. Practice hundreds more free with a trial.

Question 1

A 5-year-old has periorbital oedema, UPCR 6.0, albumin 2.0. Best initial therapy?

Question 2

Adult with nephrotic syndrome, PLA2R positive. Diagnosis?

Question 3

Serious thrombotic complication?

Question 4

First-line antiproteinuric drug in adult nephrotic syndrome?

Question 5

Which nephrotic pattern is associated with HIV?

References

Primary guidelines and peer-reviewed sources used for this entry. Reviewed 31 May 2026 by MedicoMedics editorial team.

  1. KDIGO Glomerular Diseases 2021
  2. NEJM PLA2R 2009;361:11

Frequently asked

Which pattern is most common in children?

Minimal change disease - steroid responsive.

Most common primary membranous marker?

Anti-PLA2R antibody.

Why hypercoagulable?

Urinary loss of antithrombin III.

Related conditions

High-yield topics students commonly study alongside Nephrotic Syndrome.

Ready to master this topic?

Get the full lecture, 500+ MCQs, and AI explanations with a 7-day free trial.

Start free trialBack to library