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Tubular dysfunction in nephrotic syndrome: incidence and prognostic implications
M Praga1, A Andres, E Hernandez
1Department of Nephrology, Hospital 12 de Octubre, Madrid, Spain.
Summary
Nephrotic syndrome can cause tubular dysfunction (TD), including renal glycosuria and metabolic acidosis. This complication, seen in 27.7% of patients, indicates a poorer prognosis and worsening kidney function.
Area of Science:
- Nephrology
- Internal Medicine
- Renal Medicine
Background:
- Nephrotic syndrome is a kidney disorder characterized by heavy proteinuria.
- Tubular dysfunction (TD) has been anecdotally linked to nephrotic syndrome, but its incidence and characteristics are not well-defined.
Purpose of the Study:
- To investigate the incidence and clinical characteristics of tubular dysfunction in patients with nephrotic syndrome.
- To determine if TD is associated with specific etiologies or impacts renal function and prognosis.
Main Methods:
- Studied 36 patients with nephrotic syndrome, assessing for TD markers: renal glycosuria, aminoaciduria, normal anion gap metabolic acidosis, hypouricemia, and hypophosphatemia.
- Compared patients with TD (group 1) to those without (group 2) regarding proteinuria, serum creatinine, etiology, and renal function changes over time.
Main Results:
- 27.7% of patients (10/36) exhibited TD, with renal glycosuria being the most common manifestation.
- Group 1 patients had significantly higher proteinuria and serum creatinine levels compared to group 2.
- The onset of TD correlated with a decline in renal function, with a significant increase in serum creatinine during follow-up in group 1.
Conclusions:
- Tubular dysfunction is a significant complication in a notable proportion of nephrotic syndrome patients.
- The presence of TD in nephrotic syndrome is associated with more severe disease and serves as an indicator of poor prognosis and progressive renal impairment.