Learn About Nephrotic Syndrome

What is the definition of Nephrotic Syndrome?

Nephrotic syndrome is a group of symptoms that include protein in the urine, low blood protein levels in the blood, high cholesterol levels, high triglyceride levels, increased blood clot risk, and swelling.

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What are the alternative names for Nephrotic Syndrome?

Nephrosis

What are the causes of Nephrotic Syndrome?

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 minimal change disease. Membranous glomerulonephritis is the most common cause in adults. In both diseases, the glomeruli in the kidneys are damaged. Glomeruli are the structures that help filter wastes and fluids.

Glomerulus and nephron

This condition can also occur from:

  • Cancer
  • Diseases such as diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis
  • Genetic disorders
  • Immune disorders
  • Infections (such as strep throat, hepatitis, or mononucleosis)
  • Use of certain drugs

It can occur with kidney disorders such as:

  • Focal and segmental glomerulosclerosis
  • Glomerulonephritis
  • Mesangiocapillary glomerulonephritis

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.

What are the symptoms of Nephrotic Syndrome?

Swelling (edema) is the most common symptom. It may occur:

  • In the face and around the eyes (facial swelling)
  • In the arms and legs, especially in the feet and ankles
  • In the belly area (swollen abdomen)

Other symptoms include:

  • Skin rash or sores
  • Foamy appearance of the urine
  • Poor appetite
  • Weight gain (unintentional) from fluid retention
  • Seizures
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What are the current treatments for Nephrotic Syndrome?

The goals of treatment are to relieve symptoms, prevent complications, and delay kidney damage. To control nephrotic syndrome, the disorder that is causing it must be treated. You may need treatment for life.

Treatments may include any of the following:

  • Keeping blood pressure at or below 130/80 mm Hg to delay kidney damage. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are the medicines most often used. ACE inhibitors and ARBs may also help decrease the amount of protein lost in the urine.
  • Corticosteroids and other drugs that suppress or quiet the immune system.
  • Treating high cholesterol to reduce the risk for heart and blood vessel problems -- A low-fat, low-cholesterol diet is usually not enough for people with nephrotic syndrome. Medicines to reduce cholesterol and triglycerides (usually statins) may be needed.
  • A low-sodium 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 provider may suggest a moderate-protein diet (1 gram of protein per kilogram of body weight per day).
  • Taking vitamin D supplements if nephrotic syndrome is long-term and is not responding to treatment.
  • Taking blood thinner drugs to treat or prevent blood clots.
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What is the outlook (prognosis) for Nephrotic Syndrome?

Outcome varies. Some people recover from the condition. Others develop long-term kidney disease and need dialysis and eventually a kidney transplant.

What are the possible complications of Nephrotic Syndrome?

Health problems that may result from nephrotic syndrome include:

  • Acute kidney failure
  • Hardening of the arteries and related heart diseases
  • Chronic kidney disease
  • Fluid overload, heart failure, fluid buildup in lungs
  • Infections, including pneumococcal pneumonia
  • Malnutrition
  • Renal vein thrombosis
When should I contact a medical professional for Nephrotic Syndrome?

Contact your provider if:

  • You or your child develops symptoms of nephrotic syndrome, including swelling in face, belly, or arms and legs, or skin sores
  • You or your child are being treated for nephrotic syndrome, but symptoms don't improve
  • New symptoms develop, including cough, decreased urine output, discomfort with urination, fever, severe headache

Go to the emergency room or call the local emergency number (such as 911) if you have seizures.

How do I prevent Nephrotic Syndrome?

Treating conditions that can cause nephrotic syndrome may help prevent the syndrome.

Kidney anatomy
What are the latest Nephrotic Syndrome Clinical Trials?
Thrombin Generation Assay to Assess Thrombotic Risk and the Evolution of the Hypercoagulability Profile of Patients With Nephrotic Syndrome

Summary: The thromboembolic risk is increased during the nephrotic syndrome (NS) with an incidence of deep vein thrombosis 15%, pulmonary embolism of 10-30% and renal vein thrombosis of 25-37%. There is a hemostatic imbalance with urinary leakage of anticoagulant factors and increased hepatic synthesis of procoagulant factors, platelet hyperaggregability and a decrease in fibrinolytic activity. However, th...

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Molecular and Genetic Analysis of Inherited Kidney Dysfunction

Summary: The investigators are trying to learn more about the cause of kidney diseases such as Focal Segmental Glomerulosclerosis (FSGS) and Nephrotic syndrome by studying genetics. The investigators are interested in discovering which genes play a role in causing a predisposition to FSGS/NS. The investigators also want to learn why FSGS/NS can run in families. Participation in our study involves a saliva ...

What are the Latest Advances for Nephrotic Syndrome?
Implications of rituximab pharmacokinetic and pharmacodynamic alterations in various immune-mediated glomerulopathies and potential anti-CD20 therapy alternatives.
Tacrolimus Induction Therapy for Nephrotic Syndrome Caused by Minimal Mesangial Lupus Nephritis with Lupus Podocytopathy: A Case-Based Review.
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The long-term (five years) effects of prednisone therapy in children with frequently relapsing nephrotic syndrome: A controlled study of anthropometric parameters and metabolic abnormalities.
Who are the sources who wrote this article ?

Published Date: July 27, 2021
Published By: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Erkan E. Nephrotic syndrome. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 545.

Saha MK, Pendergraft WF, Jennette JC, Falk RJ. Primary glomerular disease. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 31.