Nephrotic Syndrome: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; further:
    • Inspection (viewing).
      • Skin and mucous membranes [hypalbuminemic edema (formation of water retention in tissues that occurs due to decreased presence of albumin (protein) in the body): pretibial edema?/water retention in the area of the lower leg/pretibial tibia, ankle; in supine patients: presacral/pretuberous]
    • Auscultation (listening) of the heart.
    • Examination of the lungs
      • Auscultation of the lungs [attenuated or abolished breath sound in pleural effusion].
      • Percussion (tapping) of the lungs [muffled; Notice. Pleural effusions are more common on the right side because the pleural area is larger on that side].
    • Palpation (palpation) of the abdomen (abdomen) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing knocking pain?).
  • If necessary, cancer screening [due topossible cause: plasmocytoma (multiple myeloma) – systemic disease; belongs to the non-Hodgkin’s lymphomas of the B lymphocytes. Multiple myeloma is associated with malignant (malignant) neoplasm of plasma cells and the formation of paraproteins].
  • Urologic/nephrologic examination [due topossible causes or differential diagnoses:
    • Acute interstitial nephritis (form of kidney inflammation).
    • C1q nephropathy (rare form of inflammation of the renal corpuscles that occurs primarily in children and young adults)
    • Diabetic nephropathy (form of kidney disease caused by diabetes).
    • Glomerulonephritis (inflammation of the renal corpuscles).
      • Membranous glomerulonephritis
      • Membranoproliferative glomerulonephritis
      • Minimal change glomerulonephritis
    • Glomerulosclerosis (transformation of the renal corpuscles that can occur due to numerous diseases).
      • Diabetic glomerulosclerosis
      • Focal segmental glomerulosclerosis (FSGS) – group of chronic diseases of the kidney summarized, characterized by sclerosis (scarring) of the capillary loops of the glomerulus (renal corpuscles) visible under the light microscope.
    • Condition after renal vein thrombosis (occlusion of the renal vein by a blood clot)]
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.