Focal segmental glomerulosclerosis proteinuria

Nephrotic syndrome may complicate the course of many primary and secondary glomerulopathies. Diabetic nephropathy is the most common cause of nephrotic proteinuria (not always accompanied by full-blown nephrotic syndrome). Lupus nephritis and renal amyloidosis are much rarer secondary glomerulopathies resulting in nephrotic syndrome. The prevalence of primary glomerulopathies differs between Blacks and Whites (focal segmental glomerulosclerosis is more common... 

Nephrotic syndrome (proteinuria, edema, hypoalbumine-mia, hyperlipidemia) is a rare and idiosyncratic complication of lithium therapy it usually resolves on withdrawal, and can recur on rechallenge (397,398). Lithium-associated nephrotic syndrome occurred in a 59-year-old woman with lithium toxicity (serum concentration 1.9 mmol/1) whose renal biopsy showed focal segmental glomerulosclerosis. Lithium withdrawal led to resolution of edema and marked improvement in proteinuria and albuminemia (398). 

A 59-year-old woman with lithium-associated nephrotic syndrome (focal segmental glomerulosclerosis on biopsy) had resolution of edema and pleural effusions and marked improvement in albuminemia and proteinuria after withdrawal of lithium (398). 

A 55-year-old woman was treated with interferon alfa and ribavirin for 1 year and developed asjmiptomatic nephrotic syndrome with focal segmental glomerulosclerosis on renal biopsy (266). Proteinuria slowly improved over the next 21 months. 

Jadoul M. Interferon-alpha-associated focal segmental glomerulosclerosis with massive proteinuria in patients with chronic myeloid leukemia following high dose chemotherapy. Cancer 1999 85(12) 2669-70. 

There have been reports of nephrotic range proteinuria and focal segmental glomerulosclerosis on biopsy, in patients who are being treated with IFN-a for... 

Urinary tract A 58-year-old man with advanced renal cell carcinoma developed grade 3 proteinuria (8.5 g/24 hours) without microscopic hematuria or renal insufficiency 5 days after an infusion of temsiroli-mus [104 ]. Kidney biopsy showed ischemic glomeruli and focal segmental glomerulosclerosis. His proteinuria fell to 2.8 g/day 2 weeks after temsirolimus withdrawal. 

Several reports have linked renal dysfunction with nifedipine. In a study of hypertensive diabetics with renal insufficiency, nifedipine increased proteinuria and worsened renal function (SEDA-16, 196). Others have reported mild reversible renal impairment in patients with chronic renal insufficiency taking nifedipine for angina or hypertension a biopsy in one of the patients, who had heavy proteinuria, showed focal and segmental glomerulosclerosis (30). Immune-complex nephritis was reported in a patient taking nifedipine, but the proteinuria persisted (and indeed worsened) on changing to verapamil (31). 

The nephrotic syndrome (NS) is defined by gross proteinuria, hypalbuminaemia, and oedema. Nephrotic children are prone to thrombembolic complications, infections, and intravascular volume depletion with the risk of acute renal failure. In childhood the most common variety is idiopathic NS, but it can occur in the course of many different glomerular diseases. Mem-branoproliferative GN, membranous glomerulopathy, and lupus nephritis are frequently presenting with NS. The congenital NS of the Finnish type and familial focal and segmental glomerulosclerosis are examples for inherited forms of NS (also see Chaps. 3,21,23). 

---