Fact: Nephrotic syndrome is a collection of symptoms that indicate kidney damage
What is nephrotic syndrome?
Nephrotic syndrome is a sign that your kidneys aren't working right. As a result, you have:
- High levels of protein in your urine.
- Low levels of protein in your blood.
You may also have high levels of cholesterol in your blood.
Nephrotic syndrome isn't a disease. It's a warning that something is damaging your kidneys. Without treatment, that problem could cause kidney failure. So it's important to get treatment right away.
Nephrotic syndrome can occur at any age. But it is most common in children between the ages of 18 months and 8 years.
What are the symptoms?
Symptoms may include:
- Swelling around the eyes or in the feet or ankles. This is the most common symptom.
- Weight gain (from fluid buildup).
- Foam when urinating.
- Loss of appetite.
How is nephrotic syndrome diagnosed?
Doctors diagnose nephrotic syndrome using:
- Urine tests to measure the amount of protein in your urine.
- Blood tests to measure the amount of protein, cholesterol, and sugar (glucose) in your blood.
- Ultrasound to look at the kidneys. This test can rule out other causes of your symptoms.
A kidney biopsy may be done to find the cause. You may also have other tests to identify what is causing nephrotic syndrome.
Factors that can increase your risk of nephrotic syndrome include:
- Medical conditions that can damage your kidneys. Certain diseases and conditions increase your risk of developing nephrotic syndrome, such as diabetes, lupus, amyloidosis, minimal change disease and other kidney diseases.
- Certain medications. Examples of medications that can cause nephrotic syndrome include nonsteroidal anti-inflammatory drugs and drugs used to fight infections.
- Certain infections. Examples of infections that increase the risk of nephrotic syndrome include HIV, hepatitis B, hepatitis C and malaria.
Nephrotic syndrome is usually caused by damage to the clusters of tiny blood vessels (glomeruli) of your kidneys.
The glomeruli filter your blood as it passes through your kidneys, separating things your body needs from those it doesn't. Healthy glomeruli keep blood protein (mainly albumin) — which is needed to maintain the right amount of fluid in your body — from seeping into your urine. When damaged,
glomeruli allow too much blood protein to leave your body, leading to nephrotic syndrome.
Many possible causes
Many diseases and conditions can cause glomerular damage and lead to nephrotic syndrome, including:
- Minimal change disease. The most common cause of nephrotic syndrome in children, this disorder results in abnormal kidney function, but when the kidney tissue is examined under a microscope, it appears normal or nearly normal. The cause of the abnormal function typically can't be determined.
- Focal segmental glomerulosclerosis. Characterized by scattered scarring of some of the glomeruli, this condition may result from another disease or a genetic defect or occur for no known reason.
- Membranous nephropathy. This kidney disorder is the result of thickening membranes within the glomeruli. The exact cause of the thickening isn't known, but it's sometimes associated with other medical conditions, such as hepatitis B, malaria, lupus and cancer.
- Diabetic kidney disease. Diabetes can lead to kidney damage (diabetic nephropathy) that affects the glomeruli.
- Systemic lupus erythematosus. This chronic inflammatory disease can lead to serious kidney damage.
- Amyloidosis. This disorder occurs when substances called amyloid proteins accumulate in your organs. Amyloid buildup often affects the kidneys, damaging their filtering system.
- Blood clot in a kidney vein. Renal vein thrombosis, which occurs when a blood clot blocks a vein connected to the kidney, can cause nephrotic syndrome.
- Heart failure. Some forms of heart failure, such as constrictive pericarditis and severe right heart failure, can cause nephrotic syndrome.
Possible complications of nephrotic syndrome include:
- 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 your veins.
- High blood cholesterol and elevated blood triglycerides.When the level of the protein albumin in your blood falls, your liver makes more albumin. At the same time, your liver releases more cholesterol and triglycerides.
- Poor nutrition. Loss of too much blood protein can result in malnutrition. This can lead to weight loss, but it may be masked by swelling. You may also have too few red blood cells (anemia) and low levels of vitamin D and calcium.
- 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. If your kidneys lose their ability to filter blood due to damage to the glomeruli, waste products may build up quickly in your blood. If this happens, you may need emergency dialysis — an artificial means of removing extra fluids and waste from your blood — typically with an artificial kidney machine (dialyzer).
- Chronic kidney disease. Nephrotic syndrome may cause your kidneys to gradually lose their function over time. If kidney function falls low enough, you may require dialysis or a kidney transplant.
- Infections. People with nephrotic syndrome have an increased risk of infections.
How is nephrotic syndrome treated?
Treating nephrotic syndrome includes addressing the underlying cause as well as taking steps to reduce high blood pressure, edema, high cholesterol, and the risks of infection. Treatment usually includes medications and changes in diet.
Medications that lower blood pressure can also significantly slow the progression of kidney disease causing nephrotic syndrome. Two types of blood pressure lowering medications, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have proven effective in slowing the progression of kidney disease by reducing the pressure inside the glomeruli and thereby reducing proteinuria.
Many people require two or more medications to control their blood pressure. In addition to an ACE inhibitor or an ARB, a diuretic—a medication that aids the kidneys in removing fluid from the blood—can also be useful in helping to reduce blood pressure as well as edema. Beta blockers, calcium channel blockers, and other blood pressure medications may also be needed.Statin medications may be given to lower cholesterol.
People with nephrotic syndrome should receive the pneumococcal vaccine, which helps protect against a bacterium that commonly causes infection, and yearly flu shots.
Blood thinning medications are usually only given to people with nephrotic syndrome who develop a blood clot; these medications are not used as a preventive measure.
Nephrotic syndrome may go away once the underlying cause has been treated.
Information on this page taken directly from:
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The following are organizations and/or websites dedicated to providing information and education surrounding Neuphrotic Syndrome. These organizations are dedicated to research, education, awareness, and/or support. They are listed in Alphabetical order without any preference or prejudice. Listing these organizations is not a recommendation or referral in any regard for seeking treatment or consultation or support for treatment.
National Kidney Foundation