Nephrotic syndrome physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, Serge Korjian

A full physical examination should be performed among patients presenting with nephrotic syndrome. Findings on physical examination suggestive of secondary etiologies may be present, such as characteristic rash in systemic lupus erythematosus (SLE), or peripheral neuropathy in diabetes mellitus.

• High blood pressure, more common in adults

• May have features of underlying cause, such as rash associated with SLE

• Periorbital edema

• Pulmonary fine crackles
• Faint pulmonary auscultation, suggestive of pleural effusion
• Decreased tactile fremitus
• Dull percussion

• Abdominal distension
• Shifting dullness, suggestive of ascites
• Dull percussion

• Pitting edema in lower extremities bilaterally