Question about patho of MCNS

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Why would someone with MCNS have HTN?

It seems to me that if the oncotic pressure is decreased then the BP would go down? Does it have to do with the renin-angiotensin and ADH helping with water and sodium retention?

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Specializes in ER trauma, ICU - trauma, neuro surgical.

The loss of proteins would cause a decrease in oncotic pressure, but the body itself would be subject to massive fluid overload and edema. So, water that should have be urinated out is staying in the body. Not all pts with MCNS have HTN. Actually, some of them have normal blood pressures simply to the fact that all the fluid is 3rd-spacing (and not in the vascular space). However, once the capillary leak is bad enough, the fluid will cause pleural effusions, CHF, and anasarca. Once, that happens all those body systems go nuts and you can have all different types of issues with blood pressure. And, if someone has acute fluid overload, you can count on them being hypertensive. The heart muscle stretches, the lung stretchs, and compensatory mechanisms kick in. Basically, the pt's blood pressure is related to how well their body is handling the fluid overload.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

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minimal-change nephrotic syndrome (MCNS)

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