What is the role of nephrotic syndrome in the pathophysiology of azotemia?

Updated: Sep 19, 2018
  • Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Some patients with nephrotic syndrome may present with ARF. Impairment of capillary circulation in the kidney due to edema (nephrosarca) and tubular obstruction from protein casts, as well as decreased effective circulating volume, have been proposed as potential mechanisms for the development of ARF in patients with nephrotic syndrome.

In nephritic syndrome, the urinary sediment is active with WBC or RBC casts, granular casts, and azotemia. Proteinuria is less obvious, but increased salt and water retention in glomerulonephritis can lead to hypertension, edema formation, decreased output, low urinary excretion of sodium, and increased specific gravity.


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