Nephrotic syndrome is a group of symptoms that include
Nephrotic syndrome is caused by different disorders that damage the kidneys. This damage leads to the release of too much protein in the urine.
The most common cause in children is
This condition can also occur from:
Diseases such as
diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis
Infections (such as strep throat, hepatitis, or
Use of certain drugs
It can occur with kidney disorders such as:
Nephrotic syndrome can affect all age groups. In children, it is most common between ages 2 and 6. This disorder occurs slightly more often in males than females.
- In the face and around the eyes (
- In the arms and legs, especially in the feet and ankles
- In the belly area (
Other symptoms include:
- Foamy appearance of the urine
Poor appetite Weight gain (unintentional)from fluid retention
Exams and Tests
The doctor will perform a physical exam. Laboratory tests will be done to see how well the kidneys are working. They include:
- Blood chemistry tests such as
basic metabolic panelor comprehensive metabolic panel Blood urea nitrogen(BUN) Creatinine – blood test Creatinine clearance – urine test Urinalysis
Fats are often also present in the urine. Blood
Tests to rule out various causes may include the following:
Antinuclear antibody Cryoglobulins Complement levels Glucose tolerance test Hepatitis B and C antibodies
- HIV test
Rheumatoid factor Serum protein electrophoresis(SPEP)
- Syphilis serology
Urine protein electrophoresis(UPEP)
This disease may also change the results of the following tests:
Vitamin D level
Serum iron Urinary casts
The goals of treatment are to relieve symptoms, prevent complications, and delay
Keep blood pressure at or below 130/80 mmHg to delay kidney damage. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are the medicines most often used. ACE inhibitors may also help decrease the amount of protein lost in the urine.
You may take corticosteroids and other drugs that suppress or quiet the immune system.
Treat high cholesterol to reduce the risk of heart and blood vessel problems. A low-fat, low-cholesterol diet is usually not very helpful for people with nephrotic syndrome. Medications to reduce cholesterol and triglycerides (usually statins) may be needed.
A low-salt diet may help with swelling in the hands and legs. Water pills (diuretics) may also help with this problem.
Low-protein diets may be helpful. Your health care provider may suggest eating a moderate-protein diet (1 gram of protein per kilogram of body weight per day).
You may need
vitamin Dsupplements if nephrotic syndrome is long-term and not responding to treatment.
Blood thinners may be needed to treat or prevent blood clots.
The outcome varies. The condition may be
Some people may eventually need dialysis and a kidney transplant.
Acute kidney failure Atherosclerosisand related heart diseases Chronic kidney disease
- Fluid overload,
congestive heart failure, pulmonary edema
- Infections, including pneumococcal
Renal vein thrombosis
When to Contact a Medical Professional
Call your health care provider if:
- You have symptoms of nephrotic syndrome
- Nephrotic syndrome does not go away
- New symptoms develop, including
cough, decreased urine output, discomfort with urination, fever, severe headache
- Sores on the skin
Go to the emergency room or call the local emergency number (such as 911) if you have
Treating conditions that can cause nephrotic syndrome may help prevent the syndrome.