| Pharmacologic management of adult idiopathic nephrotic syndrome. | |
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MedLine Citation:
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PMID: 8403814 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The pathophysiology, clinical features, complications, and pharmacologic management of adult idiopathic nephrotic syndrome are reviewed. Loss of plasma proteins in the urine is the primary process leading to the nephrotic syndrome, which is characterized by hypoalbuminemia, hyperlipidemia, and edema. The four principal causes, or subclasses, of adult idiopathic nephrotic syndrome are membranous nephropathy (MN), minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), and membranoproliferative glomerulonephritis (MPGN); definitive diagnosis requires histologic examination of a renal biopsy specimen. Treatment of nephrotic syndrome may be directed at the specific cause of the proteinuria, the proteinuria itself, or the complications induced by the syndrome. The four subclasses of nephrotic syndrome vary in their response to therapy. Corticosteroids, alone or in combination with cytotoxic agents, and cyclosporine have been used to induce partial or complete remission in patients with MN, MCD, and FSGS; combinations of corticosteroids, cytotoxic agents, platelet inhibitors, and anticoagulants have been used to treat patients with MPGN. Treatment of proteinuria involves dietary protein restriction with the possible addition of an angiotensin-converting-enzyme inhibitor or a nonsteroidal anti-inflammatory drug. Management of the complications of nephrotic syndrome encompasses the use of diuretics; a low-cholesterol, low-fat diet; lipid-lowering agents; and anticoagulants. Patients with nephrotic syndrome are in a constant state of flux with respect to fluid status, organ function, and critical protein balance. Treatment is based on the histologic subclass of the disease. |
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Authors:
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C Alaniz; F C Brosius; J Palmieri |
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Publication Detail:
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Type: Comparative Study; Journal Article; Review |
Journal Detail:
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Title: Clinical pharmacy Volume: 12 ISSN: 0278-2677 ISO Abbreviation: Clin Pharm Publication Date: 1993 Jun |
Date Detail:
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Created Date: 1993-11-01 Completed Date: 1993-11-01 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8207437 Medline TA: Clin Pharm Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 429-39 Citation Subset: IM |
Affiliation:
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Department of Pharmacy Services, University of Michigan Hospitals, Ann Arbor 48109-0008. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenal Cortex Hormones
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therapeutic use Chlorambucil / therapeutic use Cyclosporine / therapeutic use Drug Therapy, Combination Edema / drug therapy, etiology Glomerulonephritis, Membranous / drug therapy Glomerulosclerosis, Focal Segmental / drug therapy Humans Nephrosis, Lipoid / drug therapy Nephrotic Syndrome* / drug therapy Proteinuria / etiology, therapy Randomized Controlled Trials as Topic |
| Chemical | |
Reg. No./Substance:
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0/Adrenal Cortex Hormones; 305-03-3/Chlorambucil; 59865-13-3/Cyclosporine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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