Abstract
In patients with kidney disease, nephrotic syndrome can lead to several complications including progressive kidney dysfunction. Proteinuria may lead to the formation of cellular or fibrous crescents with reciprocal development of rapidly progressive glomerulonephritis or focal glomerulosclerosis. Proteinuria may also cause overload and dysfunction of tubular epithelial cells, eventually resulting in tubular atrophy and interstitial fibrosis. Hypoalbuminemia is usually associated with increased risk of mortality and kidney dysfunction. Dyslipidemia may increase the risk of atherosclerotic complications, cause podocyte dysfunction and contribute to vascular thrombosis. Urinary loss of anticoagulants and overproduction of coagulation factors may facilitate a hypercoagulable state. Edema, hypogammaglobulinemia, loss of complement factors, and immunosuppressive therapy can favor infection. Treatment of these complications may reduce their impact on the severity of NS. Nephrotic syndrome is a kidney disorder that can worsen the quality of life and increase the risk of kidney disease progression.
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References
Russo LM, Sandoval RM, McKee M, Osicka TM, Collins AB, Brown D, Molitoris BA, Comper WD (2007) The normal kidney filters nephrotic levels of albumin retrieved by proximal tubule cells: retrieval is disrupted in nephrotic states. Kidney Int 71(6):504–513
Nielsen R, Christensen EI, Birn H (2016) Megalin and cubilin in proximal tubule protein reabsorption: from experimental models to human disease. Kidney Int 89(1):58–67
Molitoris BA, Sandoval RM, Yadav SPS, Wagner MC (2022) Albumin uptake and processing by the proximal tubule: physiological, pathological, and therapeutic implications. Physiol Rev 102(4):1625–1667
Russo LM, Sandoval RM, Campos SB, Molitoris BA, Comper WD, Brown D (2009) Impaired tubular uptake explains albuminuria in early diabetic nephropathy. J Am Soc Nephrol 20(3):489–499
Han Y, Ly NDK, Tesch GH, Poronnik P, Nikolic-Paterson DJ (2018) Reduced tubular degradation of glomerular filtered plasma albumin is a common feature in acute and chronic kidney disease. Clin Exp Pharmacol Physiol 45(3):241–249
Iseki K, Ikemiya Y, Iseki C, Takishita S (2003) Proteinuria and the risk of developing end-stage renal disease. Kidney Int 63(4):1468–1474
Klahr S, Levey AS, Beck GJ, Caggiula AW, Hunsicker L, Kusek JW, Striker G (1994) The effects of dietary protein restriction and blood-pressure control on the progression of chronic renal disease. Modification of Diet in Renal Disease Study Group. N Engl J Med 330(13):877–884
Ruggenenti P, Perna A, Mosconi L, Pisoni R, Remuzzi G (1998) Urinary protein excretion rate is the best independent predictor of ESRF in non-diabetic proteinuric chronic nephropathies. “Gruppo Italiano di Studi Epidemiologici in Nefrologia” (GISEN). Kidney Int 53(5):1209–1216
Rydel JJ, Korbet SM, Borok RZ, Schwartz MM (1995) Focal segmental glomerular sclerosis in adults: presentation, course, and response to treatment. Am J Kidney Dis 25(4):534–542
Cattran DC, Pei Y, Greenwood CM, Ponticelli C, Passerini P, Honkanen E (1997) Validation of a predictive model of idiopathic membranous nephropathy: its clinical and research implications. Kidney Int 51:901–907
Ponticelli C, Villa M, Banfi G, Cesana B, Pozzi C, Pani A, Passerini P, Farina M, Grassi C, Baroli A (1999) Can prolonged treatment improve the prognosis in adults with focal segmental glomerulosclerosis? Am J Kidney Dis 34(4):618–625
Ogawa-Akiyama A, Sugiyama H, Kitagawa M et al (2020) Podocyte autophagy is associated with foot process effacement and proteinuria in patients with minimal change nephrotic syndrome. PLoS ONE 15(1):e0228337
Teh YM, Mualif SA, Lim SK (2022) A comprehensive insight into autophagy and its potential signaling pathways as a therapeutic target in podocyte injury. Int J Biochem Cell Biol 143:106153
Ponticelli C, Moroni G, Reggiani F (2023) Autophagy and podocytopathy. Nephrol Dial Transplant. https://doi.org/10.1093/ndt/gfad024. (Online ahead of print)
Kriz W, LeHir M (2005) Pathways to nephron loss starting from glomerular diseases-insights from animal mode. Kidney Int 67:404–419
Anguiano L, Kain R, Anders HJ (2020) The glomerular crescent: triggers, evolution, resolution, and implications for therapy. Curr Opin Nephrol Hypertens 29(3):302–309
Smeets B, Moeller MJ (2012) Parietal epithelial cells and podocytes in glomerular diseases. Semin Nephrol 32(4):357–367
Baines RJ, Brunskill NJ (2011) Tubular toxicity of protenuria. Nat Rev Nephrol 7(3):177–180
Sharma S, Smyth B (2021) From proteinuria to fibrosis: an update on pathophysiology and treatment options. Kidney Blood Press Res 46(4):411–420
Nolin AC, Mulhern RM, Panchenko MV, Pisarek-Horowitz A, Wang Z, Shirihai O, Borkan SC, Havasi A (2016) Proteinuria causes dysfunctional autophagy in the proximal tubule. Am J Physiol Renal Physiol 311(6):F1271–F1279
Kim HJ, Moradi H, Yuan J, Norris K, Vaziri ND (2009) Renal mass reduction results in accumulation of lipids and dysregulation of lipid regulatory proteins in the remnant kidney. Am J Physiol Renal Physiol 296:F1297-1306
Kaysen GA, Gambertoglio J, Jimenez I, Jones H, Hutchison FN (1986) Effect of dietary protein intake on albumin homeostasis in nephrotic patients. Kidney Int 29(2):572–577
Pezeshki A, Zapata RC, Singh A, Yee NJ, Chelikani PK (2016) Low protein diets produce divergent effects on energy balance. Sci Rep 28(6):25145
Chrysant SG, Chrysant GS (2015) Dual renin-angiotensin-aldosterone blockade: promises and pitfalls. Curr Hypertens Rep 17(1):511
Mei M, Zhou Z, Zhang Q, Chen Y, Zhao H, Shen B (2021) Dual blockade of the renin-angiotensin system: a strategy that should be reconsidered in cardiorenal diseases? Nephron 145(2):99–106
Trujillo H, Caravaca-Fontán F, Caro J, Morales E, Praga M (2021) The forgotten antiproteinuric properties of diuretics. Am J Nephrol 52(6):435–449
Morales E, Caro J, Gutierrez E, Sevillano A, Auñón P, Fernandez C et al (2015) Diverse diuretics regimens differentially enhance the antialbuminuric effect of renin-angiotensin blockers in patients with chronic kidney disease. Kidney Int 88(6):1434–1441
Currie G, Taylor AH, Fujita T, Ohtsu H, Lindhardt M, Rossing P, Boesby L, Edwards NC, Ferro CJ, Townend JN, van den Meiracker AH, Saklayen MG, Oveisi S, Jardine AG, Delles C, Preiss DJ, Mark PB (2016) Effect of mineralocorticoid receptor antagonists on proteinuria and progression of chronic kidney disease: a systematic review and meta-analysis. BMC Nephrol 17(1):127
Kiyomoto H, Rafiq K, Mostofa M, Nishiyama A (2008) Possible underlying mechanisms responsible for aldosterone and mineralocorticoid receptor-dependent renal injury. J Pharmacol Sci 108(4):399–405
Tagawa A, Yasuda M, Kume S, Yamahara K, Nakazawa J, Chin-Kanasaki M, Araki H, Araki S, Koya D, Asanuma K, Kim EH, Haneda M, Kajiwara N, Hayashi K, Ohashi H, Ugi S, Maegawa H, Uzu T (2016) Impaired podocyte autophagy exacerbates proteinuria in diabetic nephropathy. Diabetes 65(3):755–767
Heerspink HJL, Perkins BA, David H, Fitchett DH, Husain M, David ZI, Cherney DZ (2016) Sodium glucose cotransporter 2 inhibitors in the treatment of diabetes mellitus: cardiovascular and kidney effects, potential mechanisms, and clinical applications. Circulation 134(10):752–772
Agarwal R, Acharya M, Tian J, Hippensteel RL, Melnick JZ, Qiu P, Williams L, Batlle D (2005) Antiproteinuric effect of oral paricalcitol in chronic kidney disease. Kidney Int 68:2823–2828
Cheng HF, Wang CJ, Moeckel GW, Zhang MZ, McKanna JA et al (2002) Cyclooxygenase-2 inhibitor blocks expression of mediators of renal injury in a model of diabetes and hypertension. Kidney Int 62(3):929–939
Bakhriansyah M, Souverein PC, van den Hoogen MWF, de Boer A, Klungel OH (2019) Risk of nephrotic syndrome for non-steroidal anti-inflammatory drug users: a case-control study. Clin J Am Soc Nephrol 14:1355–1362
Faul C, Donnelly M, Merscher-Gomez S, Chang YH, Franz S, Delfgaauw J, Chang JM, Choi HY, Campbell KN, Kim K, Reiser J, Mundel P (2008) The actin cytoskeleton of kidney podocytes is a direct target of the antiproteinuric effect of cyclosporine A. Nat Med 14(9):931–938
Yu H, Kistler A, Faridi MH, Meyer JO, Tryniszewska B, Mehta D, Yue L, Dryer S, Reiser J (2016) Synaptopodin limits TRPC6 podocyte surface expression and attenuates proteinuria. J Am Soc Nephrol 27(11):3308–3319
Drovandi S, Lipska-Ziętkiewicz BS, Ozaltin F, Emma F, Gulhan B, Boyer O, Trautmann A, Xu H, Shen Q, Rao J, Riedhammer KM, Heemann U, Hoefele J, Stenton SL, Tsygin AN, Ng KH, Fomina S, Benetti E, Aurelle M, Prikhodina L, Schreuder MF, Tabatabaeifar M, Jankowski M, Baiko S, Mao J, Feng C, Liu C, Sun S, Deng F, Wang X, Clavé S, Stańczyk M, Bałasz-Chmielewska I, Fila M, Durkan AM, Levart TK, Dursun I, Esfandiar N, Haas D, Bjerre A, Anarat A, Benz MR, Talebi S, Hooman N, Ariceta G, PodoNet Consortium; mitoNET Consortium; CCGKDD Consortium, Schaefer F (2022) Variation of the clinical spectrum and genotype-phenotype associations in Coenzyme Q10 deficiency associated glomerulopathy. Kidney Int 102(3):592–603
Kaysen GA (1993) The nephrotic syndrome: pathogenesis and consequences. The homeostatic and pathogenic consequences of proteinuria. Introduction. Am J Nephrol 13(5):309–310
Dogra GK, Herrmann S, Irish AB, Thomas MA, Watts GF (2002) Insulin resistance, dyslipidaemia, inflammation and endothelial function in nephrotic syndrome. Nephrol Dial Transplant 17(12):2220–2225
Soeters PB, Wolfe RR, Shenkin A (2019) Hypoalbuminemia: pathogenesis and clinical significance. JPEN J Parenter Enteral Nutr 43(2):181–193
Lang J, Katz R, Ix JH, Gutierrez OM, Peralta CA, Parikh CR, Satterfield S, Petrovic S, Devarajan P, Bennett M, Fried LF, Cummings SR, Sarnak MJ, Shlipak MG (2018) Association of serum albumin levels with kidney function decline and incident chronic kidney disease in elders. Nephrol Dial Transplant 33(6):986–992
Kikuchi H, Kanda E, Mandai S, Akazawa M, Iimori S, Oi K, Naito S, Noda Y, Toda T, Tamura T, Sasaki S, Sohara E, Okado T, Rai T, Uchida S (2017) Combination of low body mass index and serum albumin level is associated with chronic kidney disease progression: the chronic kidney disease-research of outcomes in treatment and epidemiology (CKD-ROUTE) study. Clin Exp Nephrol 21(1):55–62
Walther CP, Gutiérrez OM, Cushman M, Judd SE, Lang J, McClellan W, Muntner P, Sarnak MJ, Shlipak MG, Warnock DG, Katz R, Ix JH (2018) Serum albumin concentration and risk of end-stage renal disease: the REGARDS study. Nephrol Dial Transplant 33(10):1770–1777
Yoshimura A, Ideura T, Iwasaki S, Taira T, Koshikawa S (1992) Aggravation of minimal change nephrotic syndrome by administration of human albumin. Clin Nephrol 37(3):109–114
Klinkmann G, Klammt S, Jäschke M, Henschel J, Gloger M, Reuter DA, Mitzner S (2022) Impact of albumin binding function on pharmacokinetics and pharmacodynamics of furosemide. Medicina (Kaunas) 58(12):1780
Bockenhauer D (2013) Over- or underfill: not all nephrotic states are created equal. Pediatr Nephrol 28(8):1153–1156
Teoh CW, Robinson LA, Noone D (2015) Perspectives on edema in childhood nephrotic syndrome. Am J Physiol Renal Physiol 309(7):F575-582
Hinrichs GR, Jensen BL, Svenningsen P (2020) Mechanisms of sodium retention in nephrotic syndrome. Curr Opin Nephrol Hypertens 29(2):207–212
Larionov A, Dahlke E, Kunke M, Zanon Rodriguez L, Schiessl IM, Magnin JL, Kern U, Alli AA, Mollet G, Schilling O, Castrop H, Theilig F (2019) Cathepsin B increases ENaC activity leading to hypertension early in nephrotic syndrome. J Cell Mol Med 23(10):6543–6553
Siddall EC, Radhakrishnan J (2012) The pathophysiology of edema formation in the nephrotic syndrome. Kidney Int 82(6):635–642
Novak JE, Ellison DH (2022) Diuretics in states of volume overload: core curriculum 2022. Am J Kidney Dis 80(2):264–276
Lee TH, Kuo G, Chang CH, Huang YT, Yen CL, Lee CC, Fan PC, Chen JJ (2021) Diuretic effect of co-administration of furosemide and albumin in comparison to furosemide therapy alone: an updated systematic review and meta-analysis. PLoS ONE 16(12):e0260312
Hedin E, Bijelić V, Barrowman N, Geier P (2022) Furosemide and albumin for the treatment of nephrotic edema: a systematic review. Pediatr Nephrol 37(8):1747–1757
Masuda T, Ohara K, Nagayama I, Matsuoka R, Murakami T, Nakagawa S, Oka K, Asakura M, Igarashi Y, Fukaya Y, Miyazawa Y, Maeshima A, Akimoto T, Saito O, Nagata D (2019) Impact of serum albumin levels on the body fluid response to tolvaptan in chronic kidney disease patients. Int Urol Nephrol 51(9):1623–1629
Agrawal S, Zaritsky JJ, Fornoni A, Smoyer WE (2017) Dyslipidaemia in nephrotic syndrome: mechanisms and treatment. Nat Rev Nephrol 14(1):70
Vaziri ND (2016) Disorders of lipid metabolism in nephrotic syndrome: mechanisms and consequences. Kidney Int 90(1):41–52
Ishibashi R, Takemoto M, Tsurutani Y, Kuroda M, Ogawa M, Wakabayashi H, Uesugi N, Nagata M, Imai N, Hattori A, Sakamoto K, Kitamoto T, Maezawa Y, Narita I, Hiroi S, Furuta A, Miida T, Yokote K (2018) Immune-mediated acquired lecithin-cholesterol acyltransferase deficiency: a case report and literature review. J Clin Lipidol 12(4):888-897.e2
Haas ME, Levenson AE, Sun X, Liao WH, Rutkowski JM, de Ferranti SD, Schumacher VA, Scherer PE, Salant DJ, Biddinger SB (2016) The role of proprotein convertase subtilisin/kexin type 9 in nephrotic syndrome-associated hypercholesterolemia. Circulation 134(1):61–72
Morris AWJ (2016) PCSK9: a target for hypercholesterolaemia in nephrotic syndrome. Nat Rev Nephrol 12:510
Izquierdo-Lahuerta A, Martínez-García C, Medina-Gómez G (2016) Lipotoxicity as a trigger factor of renal disease. J Nephrol 29:603–610
Wahl P, Ducasa GM, Fornoni A (2016) Systemic and renal lipids in kidney disease development and progression. Am J Physiol Ren Physiol 310:F433–F445
Fornoni A, Merscher S (2020) Lipid metabolism gets in a JAML during kidney disease. Cell Metab 32(6):903–905
Law M, Rudnicka AR (2006) Statin safety: a systematic review. Am J Cardiol 97(8A):52C-60C
Kim BK, Hong SJ, Lee YJ, Hong SJ, Yun KH, Hong BK, Heo JH, Rha SW, Cho YH, Lee SJ, Ahn CM, Kim JS, Ko YG, Choi D, Jang Y, Hong MK, RACING investigators (2022) Long-term efficacy and safety of moderate-intensity statin with ezetimibe combination therapy versus high-intensity statin monotherapy in patients with atherosclerotic cardiovascular disease (RACING): a randomised, open-label, non-inferiority trial. Lancet 400(10349):380–390
Kerlin BA, Waller AP, Sharma R, Chanley MA, Nieman MT, Smoyer WE (2015) Disease severity correlates with thrombotic capacity in experimental nephrotic syndrome. J Am Soc Nephrol 26(12):3009–3019
Waller AP, Troost JP, Parikh SV, Wolfgang KJ, Rovin BH, Nieman MT, Smoyer WE, Kretzler M, Kerlin BA, NEPTUNE Investigators (2021) Nephrotic syndrome disease activity is proportional to its associated hypercoagulopathy. Thromb Res 201:50–59
Abdelghani E, Waller AP, Wolfgang KJ, Stanek JR, Parikh SV, Rovin BH, Smoyer WE, Kerlin BA, PNRC Investigators, NEPTUNE Investigators (2023) Exploring the role of antithrombin in nephrotic syndrome-associated hypercoagulopathy: a multi-cohort study and meta-analysis. Clin J Am Soc Nephrol 18(2):234–244
Gigante A, Barbano B, Sardo L, Martina P, Gasperini ML, Labbadia R, Liberatori M, Amoroso A, Cianci R (2014) Hypercoagulability and nephrotic syndrome. Curr Vasc Pharmacol 12(3):512–517
Li L, Zhou J, Wang S, Jiang L, Chen X, Zhou Y, Li J, Shi J, Liu P, Shu Z, Gonzalez FJ, Liu A, Hu H (2022) Critical role of peroxisome proliferator-activated receptor α in promoting platelet hyperreactivity and thrombosis under hyperlipidemia. Haematologica 107(6):1358–1373
van Geffen JP, Swieringa F, van Kuijk K, Tullemans BME, Solari FA, Peng B, Clemetson KJ, Farndale RW, Dubois LJ, Sickmann A, Zahedi RP, Ahrends R, Biessen EAL, Sluimer JC, Heemskerk JWM, Kuijpers MJE (2020) Mild hyperlipidemia in mice aggravates platelet responsiveness in thrombus formation and exploration of platelet proteome and lipidome. Sci Rep 10(1):21407
Irace C, Carallo C, Scavelli F, Esposito T, De Franceschi MS, Tripolino C, Gnasso A (2014) nfluence of blood lipids on plasma and blood viscosity. Clin Hemorheol Microcirc 57(3):267–274
Stæhr M, Buhl KB, Andersen RF, Svenningsen P, Nielsen F, Hinrichs GR, Bistrup C, Jensen BL (2015) Aberrant glomerular filtration of urokinase-type plasminogen activator in nephrotic syndrome leads to amiloride-sensitive plasminogen activation in urine. Am J Physiol Renal Physiol 309(3):F235-241
Mehta JL, Li DY, Yang H, Raizada MK (2002) Angiotensin II and IV stimulate expression and release of plasminogen activator inhibitor-1 in cultured human coronary artery endothelial cells. J Cardiovasc Pharmacol 39(6):789–794
Mahmoodi BK, ten Kate MK, Waanders F, Veeger NJ, Brouwer JL, Vogt L, Navis G, van der Meer J (2008) High absolute risks and predictors of venous and arterial thromboembolic events in patients with nephrotic syndrome: results from a large retrospective cohort study. Circulation 117(2):224–230
Kerlin BA, Ayoob R, Smoyer WE (2012) Epidemiology and pathophysiology of nephrotic syndrome-associated thromboembolic disease. Clin J Am Soc Nephrol 7(3):513–520
Suri D, Ahluwalia J, Saxena AK, Sodhi KS, Singh P, Mittal BR, Das R, Rawat A, Singh S (2014) Thromboembolic complications in childhood nephrotic syndrome: a clinical profile. Clin Exp Nephrol 18(5):803–813
Casey D, Romero K, Patel R, Ouellette T, Anasseri S, Eftekhari P (2022) Bilateral renal vein thrombosis in membranous nephropathy: hypoalbuminemia predictive of venous thromboembolism in nephrotic syndrome. Cureus 14(10):e30032
Barbour SJ, Greenwald A, Djurdjev O, Levin A, Hladunewich MA, Nachman PH, Hogan SL, Cattran DC, Reich HN (2012) Disease-specific risk of venous thromboembolic events is increased in idiopathic glomerulonephritis. Kidney Int 81(2):190–195
Kimura Y, Miura N, Debiec H, Morita H, Yamada H, Banno S, Ronco P, Imai H (2017) Circulating antibodies to α-enolase and phospholipase A2 receptor and composition of glomerular deposits in Japanese patients with primary or secondary membranous nephropathy. Clin Exp Nephrol 21(1):117–126
Díaz-Ramos A, Roig-Borrellas A, García-Melero A, López-Alemany R (2012) α-Enolase, a multifunctional protein: its role on pathophysiological situations. J Biomed Biotechnol 2012:156795
Go AS, Tan TC, Chertow GM, Ordonez JD, Fan D, Law D, Yankulin L, Wojcicki JM, Zheng S, Chen KK, Khoshniat-Rad F, Yang J, Parikh RV (2021) Primary nephrotic syndrome and risks of ESKD, cardiovascular events, and death: the kaiser permanente nephrotic syndrome study. J Am Soc Nephrol 32(9):2303–2314
Lai X, Cui Z, Zhang H, Zhang YM, Wang F, Wang X, Meng LQ, Cheng XY, Liu G, Zhao MH (2023) Long-term visit-to-visit variability in low-density lipoprotein cholesterol is associated with poor cardiovascular and kidney outcomes in patients with primary nephrotic syndrome. Int Urol Nephrol. https://doi.org/10.1007/s11255-023-03467-7. (Online ahead of print. PMID: 36648742)
Hari P, Khandelwal P, Smoyer WE (2020) Dyslipidemia and cardiovascular health in childhood nephrotic syndrome. Pediatr Nephrol 35(9):1601–1619
Alves C, Pinho JF, Dos Santos LM, Magalhães G, da Silva JM, Fontes FL, Caligiorne SM, Pinheiro S, Rodrigues-Machado MG (2020) Augmentation index, a predictor of cardiovascular events, is increased in children and adolescents with primary nephrotic syndrome. Pediatr Nephrol 35(5):815–827
Göçeroğlu A, Grenmyr E, Berden AE, Hagen EC, Bunch D, Sommarin Y, Bruijn JA, Bajema IM, Wieslander J (2018) Anti-plasminogen antibodies in ANCA-associated vasculitis: an optimized anti-plasminogen assay. PLoS ONE 13(11):e0207064
Rankin AJ, McQuarrie EP, Fox JG, Geddes CC, MacKinnon B, Scottish Renal Biopsy Registry (2017) Venous thromboembolism in primary nephrotic syndrome—is the risk high enough to justify prophylactic anticoagulation? Nephron 135(1):39–45
Sarasin FP, Schifferli JA (1994) Prophylactic oral anticoagulation in nephrotic patients with idiopathic membranous nephropathy. Kidney Int 45(2):578–585
Lee T, Biddle AK, Lionaki S, Derebail VK, Barbour SJ, Tannous S, Hladunewich MA, Hu Y, Poulton CJ, Mahoney SL, Charles Jennette J, Hogan SL, Falk RJ, Cattran DC, Reich HN, Nachman PH (2014) Personalized prophylactic anticoagulation decision analysis in patients with membranous nephropathy. Kidney Int 85(6):1412–1420
Rovin BH, Adler SG, Barratt J, Bridoux F, Burdge KA, Chan TM, Cook HT, Fervenza FC, Gibson KL, Glassock RJ, Jayne DRW, Jha V, Liew A, Liu ZH, Mejía-Vilet JM, Nester CM, Radhakrishnan J, Rave EM, Reich HN, Ronco P, Sanders JF, Sethi S, Suzuki Y, Tang SCW, Tesar V, Vivarelli M, Wetzels JFM, Lytvyn L, Craig JC, Tunnicliffe DJ, Howell M, Tonelli MA, Cheung M, Earley A, Floege J (2021) Executive summary of the KDIGO 2021 guideline for the management of glomerular diseases. Kidney Int 100(4):753–779
Kelddal S, Hvas AM, Grove EL, Birn H (2022) Safety and effectiveness of direct oral anticoagulants in patients with nephrotic syndrome: a report of 21 cases. BMC Nephrol 23(1):305
Tijani A, Coons EM, Mizuki B, Dermady M, Stanilova K, Casey AL, Alqudsi M, Gastanaduy M, Elmayan A, Bamnolker A, Velez JCQ (2022) Direct oral anticoagulants versus warfarin for venous thromboembolism prophylaxis in patients with nephrotic syndrome: a retrospective cohort study. Ann Pharmacother, 10600280221129348
Gipson DS, Messer KL, Tran CL, Herreshoff EG, Samuel JP, Massengill SF et al (2013) Inpatient health care utilization in the United States among children, adolescents, and young adults with nephrotic syndrome. Am J Kidney Dis 61:910–917
Carpenter SL, Goldman J, Sherman AK, Selewski DT, Kallash M, Tran CL, Seamon M, Katsoufis C, Ashoor I, Hernandez J, Supe-Markovina K, D’alessandri-Silva C, DeJesus-Gonzalez N, Vasylyeva TL, Formeck C, Woll C, Gbadegesin R, Geier P, Devarajan P, Smoyer WE, Kerlin BA, Rheault MN (2019) Association of infections and venous thromboembolism in hospitalized children with nephrotic syndrome. Pediatr Nephrol 34(2):261–267
Narain U, Gupta A (2018) Urinary tract infection in children with nephrotic syndrome. Pediatr Infect Dis J 37(2):144–146
Sorkhi H, Riahi SM, Ebrahimpour S, Shaikh N, Rostami A (2019) Urinary tract infection in children with nephrotic syndrome: a systematic review and meta-analysis. Microb Pathog 137:10371
El Mashad GM, El Hady Ibrahim SA, Abdelnaby SAA (2017) Immunoglobulin G and M levels in childhood nephrotic syndrome: two centers Egyptian study. Electron Physician 9(2):3728–3732
Worm M, Bohnert BN, Alenazi F, Boldt K, Klose F, Junger K, Ueffing M, Birkenfeld AL, Kalbacher H, Artunc F (2021) Proteasuria in nephrotic syndrome-quantification and proteomic profiling. J Proteomics 230:103981
Kumar M, Ghunawat J, Saikia D, Manchanda V (2019) Incidence and risk factors for major infections in hospitalized children with nephrotic syndrome. Kumar J Bras Nefrol 41(4):526–533
Vanoaica L, Richman L, Jaworski M, Darshan D, Luther SA, Kühn LC (2014) Conditional deletion of ferritin H in mice reduces B and T lymphocyte populations. PLoS ONE 9(2):e89270
Ponticelli C, Glassock RJ (2019) Prevention of complications from use of conventional immunosuppressants: a critical review. J Nephrol 32(6):851–870
Enya T, Morimoto Y, Oshima R, Miyazaki K, Miyazawa T, Okada M, Sugimoto K (2021) Nephrotic syndrome relapse in a boy with COVID-19. CEN Case Rep 10(3):431–434
Watanabe Y, Watanabe T, Ikeda H (2022) Case of recurrent refractory nephrotic syndrome in a Japanese boy with COVID-19. Pediatr Int 64(1):e14862
Morello W, Vianello FA, Proverbio E, Peruzzi L, Pasini A, Montini G (2022) COVID-19 and idiopathic nephrotic syndrome in children: systematic review of the literature and recommendations from a highly affected area. Pediatr Nephrol 37(4):757–764
Tran CL, Selewski DT, Oh GJ, Troost JP, Massengill SF, Al-Akash SI, Mahesh S, Amin R, Ashoor IF, Chanchlani R, Kallash M, Woroniecki RP, Gipson DS (2021) Pediatric immunization practices in nephrotic syndrome: an assessment of provider and parental knowledge. Front Pediatr 5(8):619548
Nakagawa N, Maruyama S, Kashihara N, Narita I, Isaka Y (2022) New-onset and relapse of nephrotic syndrome following COVID-19 vaccination: a questionnaire survey in Japan. Clin Exp Nephrol 26(9):909–916
Lim JH, Han MH, Kim YJ, Kim MS, Jung HY, Choi JY, Cho JH, Kim CD, Kim YL, Park SH (2021) J New-onset nephrotic syndrome after Janssen COVID-19 vaccination: a case report and literature review. Korean Med Sci 36(30):e218
Angeletti A, Drovandi S, Sanguineri F, Santaniello M, Ferrando G, Forno R, Cipresso G, Caridi G, Riella LV, Cravedi P, Ghiggeri GM (2020) COVID-19 in children with nephrotic syndrome on anti-CD20 chronic immunosuppression. Clin J Am Soc Nephrol 15(10):1494–1495
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Claudio, P., Gabriella, M. Nephrotic syndrome: pathophysiology and consequences. J Nephrol 36, 2179–2190 (2023). https://doi.org/10.1007/s40620-023-01697-7
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DOI: https://doi.org/10.1007/s40620-023-01697-7