Document Detail


Pharmacologic management of adult idiopathic nephrotic syndrome.
MedLine Citation:
PMID:  8403814     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
C Alaniz; F C Brosius; J Palmieri
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Clinical pharmacy     Volume:  12     ISSN:  0278-2677     ISO Abbreviation:  Clin Pharm     Publication Date:  1993 Jun 
Date Detail:
Created Date:  1993-11-01     Completed Date:  1993-11-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8207437     Medline TA:  Clin Pharm     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  429-39     Citation Subset:  IM    
Affiliation:
Department of Pharmacy Services, University of Michigan Hospitals, Ann Arbor 48109-0008.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / 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:
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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