Nephrotic syndrome
Chapter 14:Diseases of the genitourinary system
ICD-10 N04 is a billable code used to indicate a diagnosis of nephrotic syndrome.
Nephrotic syndrome is a clinical condition characterized by a triad of symptoms: significant proteinuria (greater than 3.5 grams per day), hypoalbuminemia (low serum albumin levels), and edema. It results from damage to the glomeruli, the filtering units of the kidneys, which can be caused by various underlying conditions, including primary glomerular diseases such as minimal change disease, focal segmental glomerulosclerosis, and membranous nephropathy, as well as secondary causes like diabetes mellitus and systemic lupus erythematosus. Patients often present with swelling, particularly in the legs and around the eyes, and may experience foamy urine due to the high protein content. Diagnosis typically involves urinalysis showing proteinuria, serum tests indicating low albumin levels, and renal biopsy findings that can reveal specific types of glomerular damage. Management of nephrotic syndrome focuses on treating the underlying cause, controlling symptoms, and preventing complications such as infections and thromboembolic events. This may include corticosteroids, immunosuppressive agents, diuretics, and dietary modifications.
Detailed clinical notes on symptoms, lab results, and treatment plans.
Patients presenting with edema, proteinuria, and renal function decline.
Ensure renal biopsy findings are clearly documented to support the diagnosis.
Comprehensive history and physical examination notes, including symptom assessment.
Initial evaluation of patients with suspected nephrotic syndrome.
Referral to nephrology should be documented when indicated.
Used to confirm the diagnosis of nephrotic syndrome when the underlying cause is unclear.
Pathology report and indication for biopsy must be documented.
Nephrology specialists should ensure that the rationale for biopsy is clearly stated.
The primary symptom of nephrotic syndrome is significant proteinuria, which leads to edema and hypoalbuminemia.
Diagnosis is made through urinalysis showing high levels of protein, low serum albumin levels, and often confirmed by renal biopsy.
Common treatments include corticosteroids, immunosuppressive agents, diuretics, and dietary modifications to manage symptoms and complications.