Nephrotic Syndrome

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed

Etiology/Pathophysiology:
Site of disease is the glomerulus. Over time you progressively see glomerular sclerosis, renal fibrosis, atrophy and kidney failure. The causes of nephrosis are: (1) idiopathic - most common, (2) primary renal disease - glomerulonephritis, renal vein thrombosis, (3) systemic disease - systemic lupus erythematosus, diabetes mellitus, amyloidosis, and (4) infantile - microcystic disease of the kidney.

Pathology:
Not applicable

Imaging Findings:
Acutely see bilateral nephromegaly with thinning of the calyces and infundibulum due to the nephromegaly with the renal function being normal. Later on ultrasound you will see small, shrunken, echogenic kidneys.

DDX:
Diffuse nephromegaly

• Congenital conditions - Glycogen Storage Diseases, Beckwith-Wiedemann Syndrome, Lipodystrophy, Polycystic Kidney Disease Infections
• Infectious conditions - Acute pyelonephritis, Acute glomerulonephritis
• Infiltrating conditions - Leukemia, Lymphoma, Amyloidosis, Sarcoidosis

Bilateral shrunken kidneys

• Chronic pyelonephritis - has irregular renal margins
• Chronic medical renal disease - has smooth renal margins

References:
See References Chapter.

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