Nefrosis

Nefrosis, also called nephrosis, is a noninflammatory kidney disorder characterized by damage to the glomerular filtration barrier and, less typically, the renal tubules. The term is most often used to describe the nephrotic syndrome, a cluster of findings resulting from loss of large amounts of protein in the urine. Nephrotic syndrome classically includes heavy proteinuria, hypoalbuminemia, edema, and hyperlipidemia. By contrast, nephritis denotes inflammatory kidney disease.

Nefrosis can be primary, arising from intrinsic kidney disease such as minimal change disease, focal segmental glomerulosclerosis, or membranous nephropathy; or secondary to systemic conditions such as diabetes mellitus, amyloidosis, infections, or certain drugs. The underlying cause guides treatment and prognosis.

Pathophysiology involves disruption of the glomerular filtration barrier, leading to renal protein loss and reduced plasma oncotic pressure, which promotes edema. The liver increases lipoprotein synthesis, contributing to hyperlipidemia. Management focuses on treating the underlying cause, reducing proteinuria, and addressing complications. In many cases, renin-angiotensin-aldosterone system blockers (ACE inhibitors or ARBs) reduce proteinuria and protect kidney function. Corticosteroids are standard for certain primary nephrotic diseases (notably minimal change disease in children); other immune therapies may be used for specific histologies. Supportive care includes diuretics for edema, salt restriction, vaccination, and lipid management when needed. In adults prognosis varies; children with minimal change disease generally respond well, while other forms may progress to chronic kidney disease or relapse.