Nephrol Dial Transplant (2001) 16: 221-224
© 2001 European Renal Association-European Dialysis and Transplant Association
Editorial Comments
Pathophysiology of acute renal failure in idiopatic nephrotic syndrome
Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands
Introduction
Acute renal failure (ARF) is an occasional but alarming complication of nephrotic syndrome (NS). Causes include rapid progression of the original glomerular disease, renal vein thrombosis and allergic interstitial nephritis (antibiotics, diuretics, NSAIDs). Sometimes, NS and ARF arise simultaneously following treatment with drugs such as with NSAIDs or, as described in recent years, foscarnet or interferon-alpha. In other circumstances, ARF complicates pre-existing idiopathic NS in the absence of any of the above conditions, and haemodynamic derangements are suspected. In this report I will discuss the latter.
Clinical features
An excellent overview by Smith and Hayslett [1], covering the literature until 1992, describes the following features in 75 patients with NS and ARF: (i) most patients are elderly (
60 years of age) and hypertensive; (ii) postural hypotension is not recorded; (iii) proteinuria is severe and plasma albumin approximately half the normal level; (iv) two-thirds are male; (v) most patients exhibit
Pathology
Pathophysiology
Case history
Summary
Notes
References
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