Nephrotic and nephritic syndrome patterns and the classic glomerular diseases that cause each, with their hallmark biopsy findings.
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- What is the daily urine protein excretion threshold that defines nephrotic-range proteinuria?
- More than 3.5 g per day
- What are the four classic features of nephrotic syndrome?
- Massive proteinuria, hypoalbuminemia, edema, and hyperlipidemia
- Why does hyperlipidemia occur in nephrotic syndrome?
- The liver increases lipoprotein synthesis in response to low plasma oncotic pressure from albumin loss
- What urine microscopy finding under polarized light is classic for nephrotic syndrome?
- Oval fat bodies showing a Maltese cross pattern
- What is the hallmark urinary finding of nephritic syndrome?
- Hematuria with red blood cell casts
- Besides hematuria, what other features characterize nephritic syndrome?
- Hypertension, oliguria, and mild to moderate proteinuria
- What is the most common cause of nephrotic syndrome in children?
- Minimal change disease
- What does light microscopy show in minimal change disease?
- Normal-appearing glomeruli
- What is the classic electron microscopy finding in minimal change disease?
- Diffuse effacement of podocyte foot processes
- Minimal change disease typically responds well to which treatment?
- Corticosteroids
- What is the most common cause of nephrotic syndrome in adults, especially African Americans?
- Focal segmental glomerulosclerosis (FSGS)
- What does light microscopy show in focal segmental glomerulosclerosis?
- Segmental sclerosis and hyalinosis affecting only some glomeruli
- FSGS is classically associated with which viral infection?
- HIV infection
- What is the most common cause of primary nephrotic syndrome in Caucasian adults?
- Membranous nephropathy
- What light microscopy pattern on silver stain is classic for membranous nephropathy?
- The 'spike and dome' pattern of the capillary wall