Nephrotic syndromes

Minimal change disease/Lipoid nephrosis

  • EM-fusion and effacement of epithelial foot processes.
  • MC cause of childhood nephrotic syndrome.
  • Treated with corticosteroids.
  • Good prognosis

Membranous Glomerulonephritis

  • LM-diffuse capillary and GBM thickening.
  • EM-Spike and dome pattern of basement membrane thickening.
  • MC cause of adult nephrotic syndrome.
  • A/w lymphoma,malaria,HBV,syphilis and drugs(gold,penicillamine,captopril)
  • Treat with corticosteroids.

Focal segmental Glomerulosclerosis.

  • LM-segmental sclerosis and hyalinosis.
  • A/w HIV,IV drug abuse/heroin use,idiopathic.

Diabetic nephropathy

  • LM-Kimmelstein Wilson nodular glomerulosclerosis.
  • BM thickening,increased mesangial matrix.
  • Longstanding poorly controlled diabetes.
  • Treat with ACE Inhibitors and tight sgar control.
  • ESRF in 50% patients with type 1 and 10% patients with typeII Dm within 10years of diagnosis of nephropathy.

SLE(Lupus nephritis)

  • Mesangial,membranous,focal proliferative and diffuse proliferative types.
  • LM-In class IV wireloop lesion with subepithelial deposits.
  • Classified as I-IV, nephrotic and nephritic types.
  • Positive ANA and anti-DNA antibodies.
  • Treated with prednisolone and cytotoxic drugs.
  • Prognosis linked with severity of systemic disease.

Amyloidosis

  • IF-Congo red stain,Apple green birefringence.
  • A/w Multiple myeloma,Chronic condtions,TB,Rheumatoid arthritis.

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