Nephrotic Syndrome: Symptoms, Causes and Treatment

Dr.Vikram Kalra, 2 mins read

Kidneys are a natural filtering system of the body. They have special filtering units called glomeruli. A healthy adult has around 500,000 glomeruli in each kidney.

They are small bags of capillaries that filter the blood. As the blood enters the kidneys, the glomerulus separates what the body needs and what it doesn’t. A healthy glomerulus prevents the protein (mainly albumin) from passing out with urine. Albumin is helpful in maintaining the right amount of fluid in the body.

However, some medical conditions can damage the glomeruli. This can cause too much blood protein to pass with urine, leading to a medical condition called nephrotic syndrome.

Common symptoms

• Severe swelling (edema), especially in the legs, eyes, feet or ankles
• Foamy urine due to a large amount (more than 3.5 grams) of protein in the urine
• Loss of appetite
• Fatigue
• Weight gain due to fluid retention
• Feeling unwell or sick
• Abdominal pain
• Stunted growth in children

Causes

• 
  Diabetic kidney disease: Also known as diabetic nephropathy, it is a serious complication that causes chronic kidney function loss.
• Minimal change disease: It is one of the most common causes of idiopathic nephrotic syndrome. It got its name from its appearance under a regular microscope which shows very minimal change. But when seen under a powerful electronic microscope, the real change can be observed.
• Focal segmental glomerulosclerosis: This disease causes scarring in the glomeruli. It can occur due to a genetic problem, another medical condition, certain medications or sometimes unknown reasons.
• Membranous nephropathy: In this condition, the immune system attacks the glomerulus and makes its membrane thick.
• Systemic lupus erythematosus: It is an autoimmune disease wherein the immune system mistakenly attacks healthy tissues of the kidneys.
• Amyloidosis: It is a rare disorder wherein abnormal proteins known as amyloid proteins build up in any organ. Amyloid buildup in the kidney can affect its filtering system.

Treatment
Nephrotic syndrome is not reversible on its own. However, with a proper treatment regimen, its symptoms can be managed and its progression can be stopped. In children, often this disease goes away when they reach their late teens or early 20s.

The primary focus of treatment involves treating the medical condition that might be the cause. You may also be recommended some medicines and diet modifications to reduce symptoms, swelling and risk of infection.

The medicines may include:

• Blood pressure medicines: Help reduce blood pressure and the amount of protein released in the urine.
• Diuretics: Reduce swelling by improving urine output.
  Cholesterol-reducing medicines: These medicines may sometimes help depending on the patient’s condition and lipid profile.
• Blood thinners: These anticoagulant medications are used to decrease the blood’s ability to clot.
• Immune system-suppressing medications: Immunosuppressants or immunomodulators are helpful in cases where the immune system is causing nephrotic syndrome. These drugs are to be taken under the strict supervision of a kidney doctor (nephrologist), as they can lead to complications.