Nephrotic Syndrome Differential Diagnoses

Updated: Nov 23, 2021
  • Author: Ramapriya Sinnakirouchenan, MD, MBBS; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Diagnostic Considerations

Heart failure may cause a presentation similar to that of nephrotic syndrome. In typical cases of heart failure, however, the patient will have a history of heart disease and/or features of poor heart function on exam, such as a third heart sound and even low blood pressure. In heart failure without kidney disease, the patient will have little or no proteinuria.

Nephrotic syndrome with renal impairment, such as may occur in IgA nephropathy, may cause secondary reduction in heart function, with cardiomegaly on exam. Such patients would typically be hypertensive and have substantial proteinuria on urinalysis.

Patients with cirrhosis may have substantial fluid retention, both as ascites and as peripheral edema. However, patients with cirrhosis will have little or no proteinuria unless they have associated kidney disease.

Differential Diagnoses