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Lab diag nephrotic synd 2003

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Ravi Jain
Ravi Jain

nephrotic syndrome is characterized by hypoalbuminemia, proteinuria, edema & hyperlipidemia. It is frequently found in children but also not uncommon in adults

Health & MedicineTechnology
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LAB DIAGNOSIS OF NEPHROTIC SYNDROME MODERATOR : DR SANJEEV NARANG SPEAKER : DR RAVI JAIN
NEPHROTIC SYNDROME ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
Table 2 CAUSES OF THE NEPHROTIC SYNDROME
 
NEPHROTIC SYNDROME ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HEAVY PROTEINURIA Figure 3.
Figure 4.
NEPHROTIC SYNDROME ,[object Object],[object Object],[object Object],[object Object],[object Object]
Figure 1. Nephrotic edema.
Figure 2. Nephrotic edema.
LAB DIAGNOSIS OF NEPHROTIC SYNDROME ,[object Object],[object Object],[object Object],[object Object]
LAB DIAGNOSIS OF NEPHROTIC SYNDROME ,[object Object],[object Object],[object Object],[object Object]
Protein determination in urine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PATHOPHYSIOLOGICAL CLASSIFICATION OF PROTEINURIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Difference between glomerular and Tubular proteinuria Glomerular Tubular Due to injury of Renal glomerulus Due to Injury Involving Tubulointerstitial region Comprises predominantly albumin Comprises low molecular wt protein (  2 microglobilin Protein excretion >3 – 3.5 gm/dl < 2 gm/dl. Urinary protein electrophoresis More albumin than globulin More globulin Albumin  micro globulin ratio > 1000 : 1 100:1 (N – 50-200:1) Cause -   G lomerulonephritis -          - Hypertension - Lipoid Nephrosis -    -   Pyelonephritis -    -   Interstitial Nephritis - Rejection of kidney allograft
Qualitative tests for protein ,[object Object],[object Object],[object Object],[object Object],[object Object]
Precipitation method Urine Protein: SSA
Chemical Tests on Urine: (Reagent Strip/Dipstick Analysis): Procedure
Reagent strip method ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chemical Examination – Dipstick Analysis Colour Chart
PROTEIN - URINE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PROTEIN - URINE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PROTEIN - URINE ,[object Object],[object Object],[object Object],[object Object],[object Object]
24 hour protein estimation ,[object Object],[object Object],[object Object]
24 HOUR PROTEIN ESTIMATION ,[object Object],[object Object],[object Object],[object Object]
24 HOUR PROTEIN ESTIMATION ,[object Object],[object Object],[object Object],[object Object]
24 HOUR PROTEIN ESTIMATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
24 HOUR PROTEIN ESTIMATION ,[object Object],[object Object],[object Object]
PROTEIN ELECTROPHORESIS - URINE ,[object Object],[object Object]
PROTEIN ELECTROPHORESIS - URINE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PROTEIN ELECTROPHORESIS - URINE ,[object Object],[object Object]
PROTEIN ELECTROPHORESIS - URINE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PROTEIN - SERUM ,[object Object],[object Object]
PROTEIN - SERUM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PROTEIN - SERUM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PROTEIN ELECTROPHORESIS - SERUM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PROTEIN ELECTROPHORESIS - SERUM in NEPHROTIC SYNDROME ,[object Object],[object Object],[object Object],[object Object],[object Object]
LIPID PROFILE TESTS for HYPERLIPIDEMIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CHOLESTEROL – ENZYMATIC METHOD ,[object Object]
CHOLESTEROL – ENZYMATIC METHOD ,[object Object],[object Object],[object Object],[object Object],[object Object]
TRIGLYCERIDE-ENZYMATIC METHOD ,[object Object],[object Object],[object Object],[object Object],[object Object]
TRIGLYCERIDE Concentration of TG Condition < 150 mg/dl No disease 250-500 mg/dl Peri vascular disease > 500 mg/dl High risk of pancreatitis > 1000 mg/dl 1)Hyper lipidemia type I or IV 2)Substantial risk of pancreatitis > 5000 mg/dl ,[object Object],[object Object]
HDL-CHOLESTEROL: HOMOGENOUS ASSAY ,[object Object],[object Object]
LDL-CHOLESTEROL ,[object Object],[object Object],[object Object]
VLDL-C/ PLASMA TG ratio ,[object Object],[object Object],[object Object],[object Object],[object Object]
NORMAL LEVELS S.No lipid level 1 TOTAL LIPIDS 400-800 MG/DL 2 TOTAL CHOLESTEROL 150-250 MG/DL 3 TRIGLYCERIDES 10-90 MG/DL 4 PHOSPHOLIPIDS 150-380 MG/DL 5 FREE FATTY ACIDS 9.0-15.0 MMOL/L 6 PHOSPHOLIPID PHOSPHORUS 8.0-11.0 MG/DL
LIPID PROFILE IN NEPHROTIC SYNDROME ,[object Object],[object Object],[object Object],[object Object]
SERUM CALCIUM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SERUM CALCIUM ,[object Object]
SERUM CERULOPLASMIN ,[object Object],[object Object],[object Object],[object Object],[object Object]
SERUM CERULOPLASMIN ,[object Object]
SERUM FIBRINOGEN ,[object Object],[object Object],[object Object],[object Object]
SERUM C3 COMPLEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SERUM C3 COMPLEMENT ,[object Object]
SERUM C3 COMPLEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
RENAL BIOPSY ,[object Object],[object Object]
LESIONS THAT PRESENT AS NEPHROTIC SYNDROME ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MINIMAL CHANGE GLOM. (LIPOID NEPHROSIS or NIL LESION or FOOT PROCESS DISEASE) ,[object Object],[object Object]
MINIMAL CHANGE DISEASE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MINIMAL CHANGE DISEASE ,[object Object],[object Object],[object Object]
LIPOID NEPHROSIS ,[object Object],[object Object],[object Object],[object Object]
FOCAL & SEGMENTAL GLOMERULOSCLEROSIS ,[object Object],[object Object],[object Object],[object Object]
MEMBRANOUS GN ,[object Object],[object Object],[object Object],[object Object]
MGN STAGE-II ,[object Object],[object Object],[object Object]
MGN STAGE III ,[object Object],[object Object],[object Object],[object Object]
MGN STAGE IV ,[object Object],[object Object],[object Object]
MEMBRANOPROLIFERATIVE GN ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],PAS STAIN
TYPE-II MPGN Vs NORMAL
TYPE-III MPGN ,[object Object],[object Object],[object Object]
Ig A NEPHROPATHY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DIABETIC NEPHROPATHY ,[object Object],[object Object],[object Object],[object Object],[object Object]
DIFFUSE GS ,[object Object],[object Object],[object Object]
NODULAR GS ,[object Object],[object Object],[object Object],[object Object]
RENAL AMYLOIDOSIS ,[object Object],[object Object],[object Object]
NEPHROTIC SYNDROME ,[object Object],[object Object],[object Object],[object Object]
CONGENITAL NEPHROTIC SYNDROME ,[object Object],[object Object],[object Object]
 
BY : DR RAVI JAIN ,[object Object]

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Lab diag nephrotic synd 2003

  • 1. LAB DIAGNOSIS OF NEPHROTIC SYNDROME MODERATOR : DR SANJEEV NARANG SPEAKER : DR RAVI JAIN
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  • 5. Table 2 CAUSES OF THE NEPHROTIC SYNDROME
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  • 11. Figure 1. Nephrotic edema.
  • 12. Figure 2. Nephrotic edema.
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  • 17. Difference between glomerular and Tubular proteinuria Glomerular Tubular Due to injury of Renal glomerulus Due to Injury Involving Tubulointerstitial region Comprises predominantly albumin Comprises low molecular wt protein (  2 microglobilin Protein excretion >3 – 3.5 gm/dl < 2 gm/dl. Urinary protein electrophoresis More albumin than globulin More globulin Albumin  micro globulin ratio > 1000 : 1 100:1 (N – 50-200:1) Cause -   G lomerulonephritis -          - Hypertension - Lipoid Nephrosis -    -   Pyelonephritis -    -   Interstitial Nephritis - Rejection of kidney allograft
  • 18.
  • 19. Precipitation method Urine Protein: SSA
  • 20. Chemical Tests on Urine: (Reagent Strip/Dipstick Analysis): Procedure
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  • 22. Chemical Examination – Dipstick Analysis Colour Chart
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  • 48. NORMAL LEVELS S.No lipid level 1 TOTAL LIPIDS 400-800 MG/DL 2 TOTAL CHOLESTEROL 150-250 MG/DL 3 TRIGLYCERIDES 10-90 MG/DL 4 PHOSPHOLIPIDS 150-380 MG/DL 5 FREE FATTY ACIDS 9.0-15.0 MMOL/L 6 PHOSPHOLIPID PHOSPHORUS 8.0-11.0 MG/DL
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  • 70. TYPE-II MPGN Vs NORMAL
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Editor's Notes

  1. The ability to recognize the BM as being rather uniform in thickness and density is so critically important