NEPHROTIC SYNDROME

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Def;  Nephrotic syndrome is the collection of symptoms that indicates kidney damage.
∆ It is not a disease it self
∆ It results due to glomerular damage.

Characteristics of Nephrotic syndrome:
# proteinuria
# Hyperlipidemia
#Hypoalbuminemia
# Edema

causes of Nephrotic syndrome: 
The causes are into two:
1. primary cause which includes kidney diseases only e.g focal segmental glomerulosclerosis- the main cause in adult, minimal change disease- which is the main cause in children. Etc
2. Secondary cause which includes systemic disease like: Diabetes, Lupus etc

 Symptoms of Nephrotic syndrome: 
√√  Wait gain 
√√  Swelling
√√. Fatigue
√√. Anorexia
√√. Foamy urine

Diagnosis
1. Kidney biopsy: this involves taking a piece of kidney tissue for examination with a microscope to indicate the specif underlying disease causing the said Nephrotic syndrome
2. Urine test

Complications:
I. Blood clot; due to lost of too much protein
2. Hypertension
3. Kidney failure 
4. Infection such as pneumonia, meningitis due to immunoglobulin lose
5. High cholesterol.

Management of Nephrotic syndrome
We are going to talk about the management in two phase:
1. medical management
2. Nursing management

 Medical management;
Treating nephrotic syndrome includes addressing the underlying cause as well as taking steps to reduce high blood pressure, edema, high cholesterol, and the risks of infection. Treatment usually includes medications and changes in diet.

-Medications that lower blood pressure can also significantly slow the progression of kidney disease causing nephrotic syndrome.
Drugs used includes;
1. ACE inhibitors:Reduces inside the glomeruli
2. Diuretics: Aids water removal from the kidney
3. Anticoagulants
4. Corticosteroid
Steroids: e.g Prednisone to reduce proteinuria

-Immunosuppressants: e.g cyclophosphamide to prevent frequent attacks of subacute nephritis

 Nursing management:
-Admission:admit the patient in the ward and barrier nurse to reduce infection

-Position and rest;  place patient in a Fowler's position to decrease pressure against the diaphragm
Give complete bed rest

Observations: 
Observe and report extent of oedema, hypovolemia
-monitor vital signs
-weigh patient daily
-maintain accurate fluid intake

Diet:
-Provide a diet with enough protein
-High carbohydrates
-High potassium- banana,apples, oranges
-Low sodium
-Wiegh patient daily

Give psychological care

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