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🌱 來自: Huppert’s Notes
Other Systemic Disorders Associated with Nephrotic-Range Proteinuria🚧 施工中
Other Systemic Disorders Associated with Nephrotic-Range Proteinuria
• Diabetes:
- Leading cause of glomerular disease and kidney failure in the United States
- Hyperglycemia causes hyperfiltration through the glomeruli, leading to strain, scarring, proteinuria, and, eventually, a decrease in eGFR
- Glycemic control and treatment of proteinuria may slow CKD progression
• Amyloidosis:
- Abnormally-folded proteins deposit in the glomeruli resulting in impaired function and proteinuria
- Dialysis-related amyloidosis is not typically a cause of nephrotic syndrome
• HIV-associated nephropathy (HIVAN):
- Manifests as hematuria, proteinuria, edema with enlarged kidneys
- Collapsing FSGS on pathology
- Glucocorticoids for treatment are controversial
• Lupus nephritis:
- Divided into six subclasses (class I–VI) based histological appearance. Nephrotic syndrome typically seen in class III to VI. Also see Rheumatology Chapter 9.
• Class I: Minimal mesangial LN (no changes on light microscopy)
• Class II: Mesangial proliferative LN (mesangial changes on light microscopy)
• Class III: Focal LN (<50% of glomeruli involved)
• Class IV: Diffuse LN (>50% of glomeruli involved)
• Class V: Lupus membranous nephropathy (diffuse capillary wall thickening)
• Class VI: Advanced sclerosing LN (90% sclerosing glomeruli, often bland urine sediment)