The Curbsiders Internal Medicine Podcast #250 Nephrotic Syndrome vs. Glomerulonephritis with Kidney Boy, Dr. Joel Topf
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Jan 11, 2021 
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Proteinuria Trends Indicate Cause
- Differentiating diabetic nephropathy from other causes relies on proteinuria trends over time.
- Sudden, large increases suggest non-diabetic kidney disease requiring further investigation.
Use Protein-Creatinine Ratio Early
- Use urine protein to creatinine ratio to quantify proteinuria when nephrotic syndrome is suspected.
- Ratios above 2 grams are concerning and warrant nephrology consult and possible biopsy.
Overfill Hypothesis Explains Edema
- The overfill hypothesis explains nephrotic edema as primary sodium retention by the kidney rather than low plasma albumin.
- Activation of epithelial sodium channels by filtered proteins leads to volume overload and edema.