Nephrotic syndrome is a group of symptoms that ultimately result in the body excreting too much protein in the urine; this is a condition that can have different causes. Depending on the cause and how soon treatment is started after the symptoms start, the prognosis varies. It is important that you are able to recognize the symptoms of nephrotic syndrome so you can seek medical attention if necessary.
The most common symptom of nephrotic syndrome is swelling (edema), which can occur in different areas of the body: in the face and around the eyes; in the arms, legs, feet, and ankles; and in the belly area. Other possible symptoms are foamy appearance of the urine; unwanted weight gain from fluid retention; poor appetite; and high blood pressure. If you experience any of these signs or symptoms, make an appointment with your doctor as soon as possible so a diagnosis can be made, and if necessary, treatment can be started.
The most common cause of nephrotic syndrome is damage to the clusters of tiny blood vessels (called glomeruli) of the kidneys. The glomeruli are responsible for filtering the blood as it passes through the kidneys, separating the things the body needs to get rid of and the things that the body needs to keep. When the glomeruli are working properly, they keep the blood protein in the body and prevent it from seeping out into the urine; when they aren’t working properly because of some kind of damage, the protein does escape and leave the body through the urine, leading to nephrotic syndrome. Different diseases and conditions are responsible for damaging these glomeruli. Such conditions and diseass include: minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, diabetic kidney disease, systemic lupus erythematosus, amyloidosis, blood clot in a kidney vein, and heart failure. When the cause is primary, it affects only the kidneys; when the cause is secondary, it affects other parts of the body leading to other disorders, like diabetes, systemic lupus erythematosus, or certain viral infections.
Possible complications resulting from nephrotic syndrome if it is not treated are blood clots, high blood cholesterol, elevated blood triglycerides, poor nutrition, high blood pressure, acute kidney failure, chronic kidney failure, and/or infections.
There are different exams, tests, and procedures done to diagnose nephrotic syndrome.
A urinalysis is a simple test that can reveal any abnormalities in the urine, including too much protein.
With nephrotic syndrome, a blood test may show low levels of the protein albumin and low levels of protein overall. A loss of blood protein may also cause increased levels of blood cholesterol and triglycerides. Other blood tests to be considered: creatinine and blood urea.
Kidney tissue sample
During this procedure, a special needle is inserted through the skin and into the kidney to remove a sample of the kidney for testing. This is called a kidney biopsy. The sampled tissue will be sent to a laboratory for testing.
The goals of treatment for nephrotic syndrome are to treat the underlying condition, relieve symptoms, and prevent complications.
Blood pressure medications
There are certain drugs—angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers—that reduce blood pressure when taken, and they can also reduce the amount of protein in the urine. This kills two birds with one stone.
Medications called statins can help lower blood cholesterol levels.
Anticoagulants are medications that help decrease the body’s ability to clot blood and reduce the possibility of getting blood clots, which is a complication of nephrotic syndrome.
Immune system suppressing medications
Medications that help control the immune system, like corticosteroids, can help decrease the inflammation that comes with nephrotic syndrome.
Antibiotics help control bacterial infections.
Diuretics, or water pills, help control swelling because they increase the kidneys’ fluid output.
The outcome depends on the cause of the nephrotic syndrome and whether or not it is acute and short-term or chronic and unresponsive to treatment.