The Curbsiders Internal Medicine Podcast REBOOT #250 Nephrotic Syndrome vs. Glomerulonephritis with Kidney Boy, Dr. Joel Topf
Dec 11, 2023
Dr. Joel Topf, Kashlak's esteemed Chief of Nephrology, discusses the evaluation and differentiation of nephrotic syndrome and glomerulonephritis. Topics include proteinuria evaluation, management of nephrotic syndrome, and treatment of glomerulonephritis.
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Quantifying Proteinuria
- Quantify proteinuria using a urine protein-to-creatinine ratio if a 24-hour urine collection is difficult.
- A ratio greater than 2 is abnormal, indicating glomerular damage and the need for further evaluation, potentially including a kidney biopsy.
Urine Tests for Protein
- Urine dipstick, urine albumin, and urine protein tests differ in what they measure and how they're used.
- Dipstick and urine albumin measure only albumin, while urine protein captures total protein, including albumin, globulin, and light chains.
Hypertension in Nephrotic Syndrome
- Hypertension isn't a typical characteristic of nephrotic syndrome.
- Patients with nephrotic syndrome usually present with normal blood pressure, distinguishing it from nephritic syndrome.