Nephrotic Syndrome
What is it?
Nephrotic syndrome is a kidney disorder in which high
levels of protein are released into the urine because the
kidney’s filtering mechanisms, called the glomeruli, are
damaged. This protein loss leaves low levels of protein in
the bloodstream, and causes the body to retain too much
water and salt. Also called nephrosis.
Who gets it?
People of any age and sex can develop nephrotic
syndrome. However, when this condition occurs in children,
it is more common in boys between the ages of 18 months
and 4 years.
What causes it?
Nephrotic syndrome can be caused any disease that
causes inflammation of the glomeruli. These types of
diseases are called glomerulopathies. Minimal change
disease (MCD) is the most common cause of nephrotic
syndrome in children, and is usually mild. In other cases,
the cause appears to be a malfunction of the immune
system, which could result from a virus or autoimmune
disorder such as systemic lupus erythematosus. The immune
system produces infection-fighting proteins, called
antibodies, that attack the glomeruli. Other causes of
nephrotic syndrome include certain cancers, diabetes,
allergic reactions to insect bites or poisonous plants,
allergic reactions to drugs such as intravenous heroine
and nonsteroidal anti-inflammatory drugs, and infectious
illnesses such as hepatitis B and HIV.
What are the symptoms?
The first noticeable symptom of nephrotic syndrome is
usually a foamy or frothy appearance to the urine. Other
symptoms that become more severe as the illness progresses
include general weakness, loss of appetite, fatigue, and
swelling, especially around the eyes, abdomen, ankles,
hands, and feet. The excess fluid can also enter the space
around the lungs, causing shortness of breath. Because
protein is important to maintaining muscle tone, the
muscles begin to shrink and weaken. Blood pressure may be
abnormally low or high. Lack of appetite and the loss of
essential nutrients through the kidneys result in signs of
malnourishment, such as weakened bones, poor hair and nail
health, and stunted growth in children,. As the body
weakens, it is easy for secondary infections to set in.
Problems with blood clotting are also common. Eventually,
the kidneys may fail.
How is it diagnosed?
To diagnose nephrotic syndrome, your doctor will study
your medical history and symptoms, and perform a complete
physical examination. Your doctor will check a urine
sample for high levels of protein and potassium, and low
levels of sodium. A blood test will reveal low levels of a
protein called albumin and high cholesterol levels. Some
patients may have a low red blood cell count, called
anemia. Your doctor will also take a small sample of
kidney tissue, called a biopsy, to study under a
microscope. Your doctor may perform additional tests to
determine the cause of nephrotic syndrome.
What is the treatment?
Treatment for nephrotic syndrome depends upon the
underlying cause. For example, when nephrotic syndrome is
caused by a disease, treating that disease usually
relieves the kidney symptoms. Autoimmune disorders are
treated with drugs that suppress the immune system’s
production of antibodies. Drugs called corticosteroids,
which reduce inflammation, may also be used to treat the
damaged glomeruli. Nephrotic syndrome resulting from
heroine addiction can be reversed in its early stages if
the patient breaks the addiction. Patients with symptoms
such as high blood pressure and swelling are prescribed
medications, including diuretics, to control the blood
pressure and reduce swelling by stimulating the kidneys to
produce urine. Blood clotting disorders are treated with
drugs called anticoagulants. Your doctor will recommend a
diet that includes moderate amounts of protein and
potassium, but low amounts of fats and sodium. Once kidney
failure has occurred, waste products must be removed from
the bloodstream for the kidneys through a process called
dialysis.
Self-care tips
If you have nephrotic syndrome, follow your doctor’s
recommendations for treatment. Many patients recover full
kidney function when the underlying cause of this syndrome
is treated. Patients with known allergies to insect bites,
plants, or certain drugs should avoid these triggers of
nephrotic syndrome.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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