Korean J Pediatr.  2011 Aug;54(8):322-328. 10.3345/kjp.2011.54.8.322.

Complications of nephrotic syndrome

• Park SJ
• Shin JI

• KMID: 2284326
• DOI: http://doi.org/10.3345/kjp.2011.54.8.322

Abstract

Nephrotic syndrome (NS) is one of the most common glomerular diseases that affect children. Renal histology reveals the presence of minimal change nephrotic syndrome (MCNS) in more than 80% of these patients. Most patients with MCNS have favorable outcomes without complications. However, a few of these children have lesions of focal segmental glomerulosclerosis, suffer from severe and prolonged proteinuria, and are at high risk for complications. Complications of NS are divided into two categories: disease-associated and drug-related complications. Disease-associated complications include infections (e.g., peritonitis, sepsis, cellulitis, and chicken pox), thromboembolism (e.g., venous thromboembolism and pulmonary embolism), hypovolemic crisis (e.g., abdominal pain, tachycardia, and hypotension), cardiovascular problems (e.g., hyperlipidemia), acute renal failure, anemia, and others (e.g., hypothyroidism, hypocalcemia, bone disease, and intussusception). The main pathomechanism of disease-associated complications originates from the large loss of plasma proteins in the urine of nephrotic children. The majority of children with MCNS who respond to treatment with corticosteroids or cytotoxic agents have smaller and milder complications than those with steroid-resistant NS. Corticosteroids, alkylating agents, cyclosporin A, and mycophenolate mofetil have often been used to treat NS, and these drugs have treatment-related complications. Early detection and appropriate treatment of these complications will improve outcomes for patients with NS.

Keyword

Nephrotic syndrome; Complications; Proteinuria; Child

MeSH Terms

Abdominal Pain
Acute Kidney Injury
Adrenal Cortex Hormones
Alkylating Agents
Anemia
Blood Proteins
Bone Diseases
Cellulitis
Chickens
Child
Cyclosporine
Cytotoxins
Glomerulosclerosis, Focal Segmental
Humans
Hypocalcemia
Hypothyroidism
Hypovolemia
Mycophenolic Acid
Nephrosis, Lipoid
Nephrotic Syndrome
Peritonitis
Proteinuria
Sepsis
Tachycardia
Thromboembolism
Venous Thromboembolism
Adrenal Cortex Hormones
Alkylating Agents
Blood Proteins
Cyclosporine
Cytotoxins
Glomerulosclerosis, Focal Segmental
Mycophenolic Acid