The cause of vomiting in patients with Nephrotic Syndrome
Reasons might be multiple. First of all, if nephrotic syndrome (NS) comes with decreased kidney function (uremia) vomiting ist related to poisoning with uremic toxins and is a typical syndrome. In isolated NS with sustained excretory function vomiting is not typical and frequent in general. If it comes up, it might be related to loss of both serum proteins, hormones and interstital edemous fluid deposition.
If on immunosuppressive therapy - immunosuppressant side effect likely
If any other drugs (particularly oral) - could be treatment-related
If NS and edema severe - think of swollen stomach and intestine wall and impaired absorption, motility, leaky gut etc.
1.NS causing deterioration of renal function (AKI)
2.Steroid induced gastritis.
3.Raised BP secondary to NS causing headache and vomiting.
"Pure" NS (ie. due to membranous nephropathy) without RF - unlikely to be accompanied by hypertension (intravascular volume depletion etc.) Correct me if I am wrong.
Multiple reasons can explain that. but the most frequent:
if patient has bad renal function, it could be related to uremia
if the patient is on steroids, frequent cause can be gastritis
we should also rule out infectious causes
I would add to all mentioned DDx venous thrombosis of AT and/ or PE. You can find in the literature cases description of many faces of DVT/PE presenting with vomiting.
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