18 Nephrotic Syndrome

  • may be in casts or in plasma membranes

  • mostly LDL not HDL

  • diseases damage podocytes leads to nephrotic syndrome
  • podocytes walled off from cellular components, no inflammation, no nephritic

Minimal Change Disease

  • loss of albumin (-) in urine
  • HL: massive production of cytokines

  • things trigger cytokines can trigger MCD

  • steroids help cytokines
  • most other nephrotics not responsive to steroids

  • minimal changes on renal biopsy

FSGS

  • more serious/dangerous version of MCD

  • HIV associated

  • IgM, C3

  • image: normal upright, abnormal lower left; pink deposition in abnormal

Membranous Nephropathy

  • no triggering inflammation

  • thick knots in string: Associated with membranous glomerulonephritis
  • 3 string: Associated with membranoproliferative glomerulonephritis. Tram track appearance

  • if hypercellular: membranoproliferative

  • thick GBM

  • Spike and Dome

Diabetic Nephropathy

Amyloidosis