Introduction

Triad of:
  • 1. Proteinuria (> 3g/24hr) causing
  • 2. Hypoalbuminaemia (< 30g/L) and
  • 3. Oedema

Aetiology

Primary glomerulonephritis accounts for around 80% of cases

Systemic disease (about 20%)

Drugs
  • Gold (sodium aurothiomalate), penicillamine

Others
  • Congenital
  • Neoplasia: carcinoma, lymphoma, leukaemia, myeloma
  • Infection: bacterial endocarditis, hepatitis B, malaria

Diagram showing the glomerulonephritides and how they typically present

Clinical features

Complications

  • Increased risk of infection due to urinary immunoglobulin loss
  • Increased risk of thromboembolism related to loss of antithrombin III and plasminogen in the urine. This may result in a renal vein thrombosis, resulting in a sudden deterioration in renal function
  • Hyperlipidaemia
  • Hypocalcaemia (vitamin D and binding protein lost in urine)
  • Acute renal failure