Further Outpatient Care

Management is on an outpatient basis, with emphasis on controlling blood pressure. Considerations include the following:

Observation for signs and symptoms of renal vein thrombosis, deep vein thrombosis, and pulmonary embolism is crucial
Kidney function, proteinuria (measured by the ratio of urinary protein to creatinine), and electrolytes need to be monitored at regular intervals.
Additional monitoring is indicated for pharmacologic interventions.

Complications

See the list below:

Most complications are associated with heavy proteinuria.
Serositis is a possible complication.
Hypovolemia, with the possibility of acute renal failure, may occur in patients who are overdiuresed. Hypovolemia exacerbates the adverse renal effects of ACE inhibitors, ARBs, and NSAIDs.
Increased incidence of infection may be present, even in patients not receiving immunosuppressives.
Hyperfibrinogenemia and erythrocytosis may lead to a hypercoagulable state, particularly renal vein thrombosis. Nephrotic syndrome may also result in loss of antithrombin III.
Lethargy and tiredness are complications.
An increased incidence of ischemic heart disease has not been proven.

Prognosis

See the list below:

The outcome depends on the renal function at the time of diagnosis and the amount of proteinuria, ranging from remission without medication to ESRD.

Patient Education

See the list below:

For excellent patient education resources, visit eMedicineHealth's Infections Center and Digestive Disorders Center. Also, see eMedicineHealth's patient education articles Liver Transplant, Hepatitis B, Hepatitis C, and Cirrhosis.

Questions

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