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Each year, eight new residents begin their training in the Queen's-Bowmanville-Oshawa-Lakeridge Family Medicine Program. Nephrotic syndrome (or nephrosis) is characterized by marked proteinuria, hypoalbuminemia, hyperlipemia, and edema. With minimal change disease (lipid nephrosis or nil disease)—the main cause of nephrotic syndrome in children—the glomeruli appear normal by light microscopy. Membraneous glomerulonephritis—the most common lesion in patients with adult idiopathic nephrotic syndrome—is characterized by uniform thickening of the glomerular basement membrane containing dense deposits. Focal glomerulosclerosis can develop spontaneously at any age, follow kidney transplantation, or result from heroin abuse.
With membranoproliferative glomerulonephritis, slowly progressive lesions develop in the subendothelial region of the basement membrane. The dominant sign of nephrotic syndrome is mild to severe dependent edema of the ankles or sacrum, or periorbital edema, especially in children. Accompanying signs and symptoms include orthostatic hypotension, lethargy, anorexia, depression, and pallor. Effective treatment of nephrotic syndrome necessitates correction of the underlying cause, if possible. Some patients respond to a course of corticosteroid therapy (such as prednisone), followed by a maintenance dose.
Measure blood pressure while the patient is in a supine position and also while he's standing; be alert for a drop in blood pressure that exceeds 20 mm Hg. Monitor intake and output, and check weight at the same time each morning—after the patient voids and before he eats—and while he's wearing the same kind of clothing.


Watch for and teach the patient and family how to recognize adverse reactions to drug therapy. Offer the patient and family reassurance and support, especially during the acute phase, when edema is severe and the patient's body image changes. Melanie received her nursing degree from East Carolina University and her Master of Science in nursing from the University of North Carolina at Chapel Hill. Whether you need treatment for the common cold, annual flu shots or help getting your cholesterol or blood pressure under control our Primary Care Department is your best choice. Click below for a brief program description and to view our calendar of upcoming events and programs. Although nephrotic syndrome isn't a disease itself, it results from a specific glomerular defect and indicates renal damage. Lesions initially affect the deeper glomeruli, causing hyaline sclerosis, with later involvement of the superficial glomeruli. These diseases increase glomerular protein permeability, leading to the increased urinary excretion of protein, especially albumin, and subsequent hypoalbuminemia. Major complications are malnutrition, infection, coagulation disorders, thromboembolic vascular occlusion, and accelerated atherosclerosis.
Serum values that support the diagnosis are increased cholesterol, phospholipid, and triglyceride levels and decreased albumin levels. Patients with chronic nephrotic syndrome that's unresponsive to therapy may require vitamin D replacement. Hodges completed her master of medical science at Emory University School of Medicine and master of science in clinical research at Campbell University School of Pharmacy.


Before becoming a family nurse practitioner, Melanie worked as a nurse in a variety of inpatient settings for 8 years. Harris received her Bachelor and Master of Science degrees in nursing from East Carolina University. He completed his residency in family medicine at Madigan Army Medical Center in Tacoma, WA.
Prior to joining Knightdale Family Medicine in 2009, she worked as a physician assistant in North Carolina.
Having a doctor you know and trust direct your care is essential in assuring you and your family get the care you need, when you need it. She enjoys meeting the individual health care needs of patients of all ages (infants to the elderly), from preventive care to chronic and acute illnesses. She enjoys meeting the individual health care needs of patients of all ages (infants to the elderly), from offering preventive care to managing chronic and acute illnesses.
He was also deployed to Iraq and provided emergency and routine care to soldiers in combat.
She is board-certified in family practice and is a member of the American Academy of Family Physicians, American Medical Association and North Carolina Medical Society. Bob.” He is board-certified in family medicine and has additional training in obstetrics and gynecology, dermatology and minor office procedures.



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