Secondary Nephrotic Syndrome results from many inducements. However, most of inducements are different disease. This text will discuss the main causes of Secondary Nephrotic Syndrome:
Nephrotic syndrome is characterized by high protein excretion, peripheral edema, and metabolic abnormalities .Consists of clinical and laboratory abnormalities common to several primary and secondary kidney diseases, each characterized by increased permeability of the glomerular capillary wall to circulating plasma proteins, particularly albumin .Presents with edema, hypoalbuminemia, and massive proteinuria (3.5 g/24 h or greater), hypertension, and hyponatremia.
It is commonly seen in diabetic patients with more than ten years' medical history, especially in diabetes type II patients who fail to control their condition. In the early stage of diabetic nephropathy, proteinuria and neprhotic syndrome is common to see. Fundus examination may show microaneurysm, kidney enlargement, an elevated level in renal plasma flow and GFR (glomerular filtration rate) etc. In the end stage, renal function declines.
2. Systemic lupus erythematosus.
About 20%~40% female patients with systemic lupus erythematosus can be found to get neprotic syndrome, whose typical symtomes are fever, ransh and arthralgia, as well as butterfly rash in face. In histology, serum antinuclear antibody, anti-dsDNA, Styrene monomer antibody presents positive and a descended level in complete3, as well as an elevated level in SPEP a2 and globulin. In immune globulin test, IgG increases. And in renal biopsy, pathologic changes are characterized by variety, except mesangial proliferation.
3. Amyloid nephropathy
It has tow forms: primary and secondary. The latter one results from chronic infection (tuberculosis, leprosy etc), tumor and multiple myeloma as well as rheumatoid arthritis. At the same time, most patients may be followed by cardiac hypertrophy, arrhythmia, heart failure, hepatosplenomegaly, macroglossia and myxedema in skin. In the early stage, amyloid nephropathy is only accompanied by proteinuria. 3 to 5 years later, nephritic syndrome appears, which is together with the increase of serum globulinγ, unobvious Hyperlipidemia.
4. Cancer.
All kinds of cancer can result in nephritic syndrome, such as breast cancer, lung cancer, gastric cancer and lymphoproliferative disease. Therefore, it is necessary for patients with nephritic syndrome to take overall test. If general lymphadenectasis or abdominal mass are found, it may indicate nephrotic syndrome induced by tumor. So patients should get the exact diagnose timely.
It is commonly seen in teenagers and manifests nephritic syndrome in clinic, which mainly presents purpura, stomachache and arthralgia in the end of limbs.
Children with nephrotic syndrome will outgrow it by the time they reach young adulthood. In the rare case when a child needs a kidney transplant, we have a protocol that decreases the chance that the nephrotic syndrome re-appears in the new organ from 50 percent to 20 to 30 percent
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