Nephrology Question 27 Instructor

What are the 3 primary glomerular diseases that cause nephrotic syndrome, and name 3 secondary causes of each?

The term nephrotic syndrome refers to a distinct constellation of clinical and laboratory features of renal disease. It is specifically defined by the presence of:

  • Heavy proteinuria (>3.5 g/24 hours)
  • Hypoalbuminemia
  • Peripheral edema
  • Hyperlipidemia

Thrombotic disease may also be observed.

The classification is based on pathological findings:

  • minimal change disease
  • focal segmental sclerosis (FSGS)
  • membranous nephropathy

Sometimes there can be associated secondary diseases that may be causative in nature.

Minimal change:

  • Drugs: NSAIDs, ampicillin, lithium
  • Cancer: Hodgkin’s lymphoma, other lymphoproliferative diseases
  • Toxins: mercury, lead, bee stings
  • Infection: mononucleosis, HIV, immunizations


  • Unilateral renal agenesis
  • Renal ablation – remnant kidney
  • Sickle cell disease
  • Morbid obesity
  • Heroin nephropathy
  • HIV nephropathy
  • Pamidronate
  • Vesicoureteral reflux


  • Immunologic disorders eg. SLE, RA, MCD
  • Neoplasms e.g. Carcinoma (lung, colon, breast etc.), melanoma, leukemia, lymphoma
  • Infections e.g. Hepatitis B, syphilis, malaria
  • Medications e.g. Penicillamine, gold, captopril

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