Nephrotic Syndrome: from pathophysiology to clinical management

Abstract

Nephrotic syndrome is a clinical condition characterized by massive proteinuria, hypoalbuminemia, generalized edema, and hyperlipidemia, resulting from various underlying causes, including primary and secondary glomerular diseases. This syndrome affects both children and adults, with clinical manifestations varying according to etiology, age of onset, and response to treatment. The pathophysiology of nephrotic syndrome involves a complex interaction of immunological, inflammatory, and genetic factors that compromise the glomerular filtration barrier, leading to excessive loss of plasma proteins in the urine. Clinical management includes symptom control, complication prevention, and, when possible, treatment of the underlying cause. Therapeutic options range from the use of corticosteroids to immunosuppressants and biological agents, depending on the patient’s response and disease severity. The prognosis of nephrotic syndrome depends on several factors, including the underlying cause, response to treatment, and the presence of complications. Recently, advances in understanding the pathogenesis of nephrotic syndrome and the development of new treatments have improved management prospects and patient quality of life.