Nephrotic Syndrome for the Internist

Nephrotic syndrome (NS) is a key clinical entity for the internist to recognize and understand. A wide range of infectious, metabolic, malignant, and autoimmune processes drive nephrosis , leading to a syndrome defined by proteinuria , edema, and hypoalbuminemia . NS occurs due to increased permeability to proteins at the level of the glomerulus , which allows for passage of albumin and other proteins into the urine. Proteinuria leads to a cascade of clinical complications characterized by fluid accumulation, kidney inflammation , and dysregulation of coagulation and immunity. In this article, the authors review the clinically important etiologies of NS that should inform an initial clinical evaluation