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6. Renal vein thrombosis.


7. Congenital and familial conditions.

Pathology:
See pathologic classification of glomerular diseases (Page 16).

Pathogenesis:
Hypoalbuminemia
Is mainly due to loss of albumin through the kidney as a result of
the glomerular disease. However, there are other factors which increase
the magnitude of this problem such as:

1. The decreased intake (due to anorexia) and decreased absorption
   (due to oedema of the intestinal wall).


2. The increased concentration of albumin in the glomerular filtrate
   which is accompanied by increase in its catabolism by the renal
   tubules.


3. The partitioning of albumin between extra-and intravascular spaces;
   and


4. Sometimes decreased rate of hepatic biosynthesis of albumin.

Oedema:
The mechanisms incriminated in pathogenesis of oedema in
nephrotic patient include the following (Fig. 3.7).

1. Hypoalbuminaemia results in a decrease in plasma oncotic (osmotic)
   pressure which is the power keeping water in the intravascular space.
   Consequently, water leaks to the interstitial space with formation of
   edema.