Nephrotic syndrome is a disorder caused by damage to the small blood vessels in your kidneys that filter waste and excess water from your blood. When healthy, these small blood vessels keep blood protein from seeping into your urine and out of your body.

Nephrotic syndrome is a disorder caused by damage to the small blood vessels in your kidneys that filter waste and excess water from your blood. When healthy, these small blood vessels keep blood protein from seeping into your urine and out of your body. When damaged, they don't perform this function effectively, and protein can leak out of your blood and lead to swelling (edema).

Features of nephrotic syndrome:

Nephrotic syndrome, which is characterized by:

• High levels of protein in your urine (proteinuria)
• Low levels of the blood protein albumin (hypoalbuminemia)
• Elevated blood levels of cholesterol and triglycerides
• Swelling (edema).

 

Childhood nephrotic syndrome can occur at any age but is most common between the ages of 1½ and 5 years. It seems to affect boys more often than girls.

A child with nephrotic syndrome has these signs:

• High levels of protein in the urine, a condition called proteinuria.
• Low levels of protein in the blood.
• Swelling resulting from buildup of salt and water.
• Less frequent urination.
• Weight gain from excess water.
• Swelling (edema), particularly around your eyes and in your ankles and feet.
• Foam in the toilet water, which may be caused by excess protein in your urine.
• Loss of appetite.
• Vomiting.

 

Nephrotic syndrome is not itself a disease. But it can be the first sign of a disease that damages the kidney’s tiny blood-filtering units, called glomeruli, where urine is made.

Diagnosis of nephritic syndrome:

• Urine examination of protein.
• Renal function tests like blood urea, serum creatinine.
• Blood tests for serum albumin.
• Kidney biopsy.
• Causes of child hood nephrotic syndrome:
• Minimal change disease.
• Focal segmental glomerulonephritis and membranoproliferative glomerulonephritis.
• Congenital nephropathy.
• Dehydration due to severe vomiting or diarrhea.

Points to Remember:

• Nephrotic syndrome is a set of signs or symptoms that may point to kidney problems.
• Childhood nephrotic syndrome is most common between the ages of 1½ and 5 years.
• Nephrotic syndrome causes proteinuria, low levels of protein in the blood, less frequent urination, and swelling and weight gain from the buildup of fluid.
• Diagnosis of nephrotic syndrome requires urine and blood samples and may include a kidney biopsy.
• Most cases of childhood nephrotic syndrome result from minimal change disease.
• The two most common diseases that damage the kidneys’ tiny blood-filtering units and cause nephrotic syndrome are focal segmental glomerulosclerosis (FSGS) and membranoproliferative glomerulonephritis (MPGN).
• Congenital nephropathy is a rare condition that causes nephrotic syndrome in newborns.

Complications of nephrotic syndrome:

• Blood clots: The inability of the glomeruli to filter blood properly can lead to loss of blood proteins that help prevent clotting. This increases your risk of developing a blood clot (thrombus) in veins.
• Poor nutrition: Loss of too much blood protein can result in malnutrition. This can lead to weight loss, but it may be masked by edema.
• High blood pressure: Damage to your glomeruli and the resulting buildup of wastes in your bloodstream (uremia) can raise your blood pressure.
• Acute kidney failure.
• Chronic kidney failure.
• Increased risk of infection.

Treatment:

• Diuretics, such as thiazide diuretics, furosemide (Lasix) or spironolactone, to increase your kidneys' output of water and sodium and control edema.
• Statins, such as atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Altoprev, Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor) or simvastatin (Zocor), to lower blood cholesterol.
• Blood thinners (anticoagulants), such as heparin or warfarin (Coumadin), which decrease your blood's ability to clot and reduce your risk of developing blood clots
• Immunosuppressive medications, such as corticosteroids, to decrease the inflammation that accompanies kidney disorders, such as membranous nephropathy
• Antibiotics to control infection.