GuidelinesEML (Adult Hospital STG)
Nephrotic Syndrome
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition
N04.9
DESCRIPTION
Glomerular disease is characterised by:
- Nephrotic-range proteinuria, i.e.: UPCR >0.35 g/mmol
AND
LoE:IVbxvi
- oedema,
- hypoalbuminaemia, and
- hyperlipidaemia.
The cause cannot be determined accurately without a kidney biopsy. With the exception of diabetic nephropathy, all other causes of nephrotic syndrome require specialist consultation.
GENERAL MEASURES
- Regulate salt and fluid intake.
- Weigh regularly to assess fluid retention.
- Check for postural hypotension to identify excessive diuresis.
- Evaluate proteinuria with PCR:
- initially – weekly
- when discharged – monthly, until stable
- Monitor potassium frequently for patients on ACE inhibitors and/or diuretics.
MEDICINE TREATMENT
Management should be guided by a specialist.
CONSULTATION/REFERRAL
All patients.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Adult Hospital Level, 2020-2024_Version 1.0_17 October 2024
Chapter 7 Nephrology/Urological Disorders_7.1 Nephrology Disorders_7.1.3 Nephrotic Syndrome