Complications

The complications of nephrotic syndrome include:

• renal vein thrombosis
• arterial thrombosis
• infection:
  • patients with nephrotic syndrome are prone to infection with all organisms but especially pneumococcus, particularly pneumococcal peritonitis
  • susceptibility due to loss of IgG and alternative pathway complement components in the urine
  • any infection should be treated early with intravenous broad spectrum bactericidal antibiotics
• hypovolaemic shock and acute renal failure, with signs of severe renal hypoperfusion leading to temporary oliguria and increasing uraemia:
  • management involves volume replacement followed by diuretics
  • there is a strong case for the administration of antibiotics to cover the possibility that the hypoperfusion may be a result of septicaemia
  • a few patients may deteriorate and require dialysis
    
    
• iron deficiency due to loss of transferrin and iron
  
  
• muscle wasting
  
  
• accelerated atherosclerosis