Hypovolemic Shock and Hypotension as a Complication in the Nephrotic Syndrome

Nephrotic Syndrome Secondary to Lithium Therapy

“…The mild degree of renal failure she exhibited was likely a consequence of the nephrotic state (not lithium toxicity), as evidenced by the high serum urea nitrogen/creatinine ratio and low urine sodium concentration. Similar degrees of 'prerenal' failure are seen in patients with nephrotic syndrome of other etiologies [18].…”

Blood Volume and Sodium Retention in the Nephrotic Syndrome: A Controversial Pathophysiological Concept

“…Fainting was indeed mentioned as a frequent symptom in one study [112] but not in most other reports [33,43]. Hypovolemic shock has been observed in the NS by some investigators [22,54], One report described 10 such pa tients 2 of whom died despite intravascular expansion treatment [113]. In 3 of them, shock occurred 'spontane ously', but in the others it followed surgical procedures, bleeding episodes or vasodilating drugs.…”

Reversible Acute Renal Failure in Idiopathic Nephrotic Syndrome.

“…Several possible mechanisms for acute renal insufficiency in the nephrotic syndrome include hypovolemia (5), alterations in intrarenal hemodynamics (6), renal vein thrombosis (7), drug-induced interstitial nephritis (8), ischemic acute tubular necrosis (9,10) and tubular obstruction by proteinaceous casts (ll). Lowenstein et al (12) has postulated that the reduced glomerular filtration rate is associated with renal interstitial edema.…”