Medical Archive

C543 Clinical Evaluation Of The Child With Proteinuria

C544 Conditions Associated With Proteinuria

C545 Nephrotic Syndrome

????? ?? ??: >3.5g/1.73m2/d
????? ?? ??: >40mg/m2/hr (?? ?? 2g)

?????? <2.5g/dL
?????? ?? >200~250mg/dL
?? ??

Diagnostic approach

• ??? MCN? ?????? ? ?? ?? ?? ?? ?????? ??.
• ???? ?? ???? ??
  • ???(12? ??)
  • ??, ???, ?? Cr ??, HBsAg(+), ?? C3 ??

Disease entities

Minimal change nephrotic syndrome

95%?? ?????? ??

Mesangial proliferative glomerulonephritis

50-60%?? ?????? ??

FSGS, focal segmental glomerulosclerosis

? 20%??? ?????? ??

MPGN, membranoproliferative glomerulonephritis

?? ??? ??, ??, ???, ???? ??.

Complications

• ??? ???
  • S.pneumoniae – m/c
  • ??, ??, ??, ?? ??? ??? ??
• ?? ??? ?? (hypovolemic crisis)
  • MCN?? ? ??. ??? ??? ?? ??? ??? ???? ??? ??.
  • ??? ????? ???? ??? ? ???, ? ? 20% ??? ??.
• ???
  • ??, ?? ??? ???

Treatment

• ??: ??? ?? ??? ??? ?? ?? (<2g/d), ?? ?? ??, ???? ??? ? ??
• ???: ??? ?? ?? ?, 20% albumin + furosemide
• ?????
  • Steroid
  • Cyclophosphamide: ?? ????? ?? ????? ???.
  • Cyclosporine