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# MCNS ## Symptoms of MCNS include: - Edema, often beginning with periorbital edema on awakening and peripheral edema later in the day. - Hypertension. - Pallor. - Anorexia but with weight gain. Malnourishment (protein loss). - Irritability. - Frothy, foamy urine. - Pleural effusion, dyspnea. - Abdo...

# MCNS ## Symptoms of MCNS include: - Edema, often beginning with periorbital edema on awakening and peripheral edema later in the day. - Hypertension. - Pallor. - Anorexia but with weight gain. Malnourishment (protein loss). - Irritability. - Frothy, foamy urine. - Pleural effusion, dyspnea. - Abdominal pain, nausea and vomiting. - Pale, shiny skin with prominent veins, brittle hair. - Progression to acute or chronic renal failure in some cases. ## Diagnosis is made by the following: - Hypoalbuminemia < 25 g/L. - Protein excretion (urine) ≥40 mg/m2/hr. - Renal ultrasound. - Hematuria. - Relapse: Dipstick check of protein 2+ for 3 consecutive days. ## Treatment includes: - Corticosteroids (Prednisone) p.o. daily for 6 weeks and the every other day for an additional 6 weeks. - Diuretics. - IV albumin if non-responsive to diuretics. - Relapse: Immunosuppressant or immunomodulator agents (Cyclophosphamide, cyclosporine, chlorambucil, levamisole). # Acute Renal Failure Acute renal failure (ARF) is abrupt and almost complete failure of kidney function with decreased glomerular filtration rate (GFR), occurring over a period of hours/days. It most commonly occurs in hospitalized children. The BUN increases and nitrogenous wastes are retained (azotemia). There are 3 primary categories: prerenal (renal hypoperfusion) intrarenal (primary kidney damage) and postrenal (obstruction). Nephrotic syndrome is an intrarenal cause. ARF is usually triggered by acute tubular necrosis in children. ## Symptoms include: - Urine: Dark, gross hematuria, oliguria - Headache - Edema - Nausea, vomiting - Hypertension - Anemia, fatigue - Metabolic acidosis - Electrolyte imbalances