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Nephrotic Allergic
Syndrome Infection
Liver failure Lymphatic
Congestive obstruction
heart failure (Filariasis)
A. Periorbital edema in Nephrotic syndrome (Puffiness in morning)
B. Ascites in Liver cirrhosis
C. Pitting pedal edema in Congestive heart failure
D. Unilateral edema of lymphedema
How to differentiate generalized
edema and localized edema?
Generalized edema
Pitting
Onset : gradually
Need longer time to subside
Localized edema
Non-pitting
Onset : sudden
Less time to subside
Proteinuria
Definition:
Orthostatic proteinuria
Glomerular abnormalities
(glomerulonephritis, min. change
disease)
Increased glomerular filtration
pressure
Hypertension
Tubular proteinuria
Types of proteinuria
Transient
Postural (orthostatic)
Glomerular
Tubular
Transient proteinuria
During febrile illness/after exercise and does
not require investigation
Proteinuria usually mild U Pr/Cr <1, resolves
within few days
Not indicate renal disease
Postural (orthostatic) proteinuria
Normal excretion while recumbent
Common in adolescent, tall, thin individual
Diagnosed by measuring the urine protein/
creatinine ratio in a series of early morning
urine specimen
Tubular proteinuria
Low-molecular-weight protein in the urine
and is suspected with acute tubular necrosis,
pyelonephritis, structural renal disorder,
polycystic kidney disease and tubular toxins
(antibiotic and chemotherapeutic agents)
Increased filtration, impaired reabsorption or
secretion of proteins
Glomerular proteinuria
Combination of large/small-molecular-weight protein
in the urine, and often evidence of glomerular disease