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Causes of Nephrotic Syndrome

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Causes	Examples
Primary causes
Idiopathic	Fibrillary and immunotactoid GN Focal segmental glomerulosclerosis IgA nephropathy* Membranoproliferative GN* Membranous nephropathy Minimal change disease Rapidly progressive GN*
Secondary causes
Metabolic	Amyloidosis Diabetes mellitus
Immunologic	Cryoglobulinemia* Immunoglobulin A vasculitis* Microscopic polyangiitis Serum sickness Sjögren syndrome Systemic lupus erythematosus*
Idiopathic	Castleman disease Sarcoidosis
Neoplastic	Carcinoma (eg, bronchus, breast, colon, stomach, kidney) Leukemia Lymphomas Melanoma Multiple myeloma
Drug-related	Gold Heroin Interferon alfa Lithium NSAIDs Mercury Pamidronate Penicillamine Probenecid
Bacterial†	Infective endocarditis Leprosy Syphilis
Protozoan†	Filariasis Helminthic infections Malaria Schistosomiasis (due to Schistosoma haematobium)
Viral†	Epstein-Barr virus infection Hepatitis B and C HIV infection
Allergic	Antitoxins Insect stings Snake venom
Genetic syndromes	Congenital nephrotic syndromes Corticosteroid-resistant nephrotic syndrome (podocin defect) Denys-Drash syndrome Diffuse mesangial sclerosis Familial FSGS Finnish type (ie, nephrin gene mutation) Nail-patella syndrome Fabry disease Alport syndrome* Sickle cell disease
Physiologic	Adaptation to reduced nephrons Severe obesity Oligomeganephronia
Miscellaneous	Chronic allograft nephropathy Malignant hypertension Preeclampsia
* More commonly manifests as nephritic syndrome.
† Infectious and postinfectious causes.
FSGS = focal segmental glomerulonephritis; GN =glomerulonephritis; NSAID = nonsteroidal anti-inflammatory drug.