THE nephrotic syndrome in adults occurs mainly as a distressing manifestation of certain types of renal disease. For the present purposes, the syndrome is defined as the complex of the following signs and laboratory findings: edema or anasarca, hypoalbuminemia, proteinuria, and hypercholesterolemia. The usual complaint of patients with the nephrotic syndrome is edema. The edema is a reflection of the retention of salt and water; the proteinuria and the consequent depletion of the plasma proteins play an important role in its development. The proteinuria is the result of an abnormally high permeability of the glomerular capillaries to proteins.
The usual therapeutic goal is to rid the patient of edema. Therapy designed to reach this goal can be directed to the reversal of the increased glomerular permeability or to the relief of the edema without necessarily achieving reduction of the glomerular permeability.
The nephrotic syndrome that occurs in adults differs in