Learn About Nephrotic Syndrome
Nephrotic syndrome is a group of symptoms and abnormal test results 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.
Nephrosis
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.
This condition can also occur due to:
- 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.
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
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.
Atrium Health Levine Children's Nephrology
Susan Massengill is a Pediatric Nephrologist and a Pediatrics provider in Charlotte, North Carolina. Dr. Massengill is rated as an Elite provider by MediFind in the treatment of Nephrotic Syndrome. Her top areas of expertise are Nephrotic Syndrome, Focal Segmental Glomerulosclerosis, Minimal Change Disease, Glomerulonephritis, and Kidney Transplant. Dr. Massengill is currently accepting new patients.
Duke Children's Health Center Kidney Transplant Clinic
I am a pediatric nephrologist and work with children with kidney disease. Some of the conditions that we see include congenital malformations of the kidney and the bladder, nephrotic syndrome, glomerulonephritis (inflammation of the kidney filters), and children who are on dialysis or who received kidney transplantation because of kidney failure. I listen carefully to parents when they bring their children to the clinic because they know their children better than any other person, and they are the best advocates for their child. I collaborate a lot with the other doctors in the clinic. Rest assured, when you visit our clinic and I am not around, the doctor who is seeing you knows everything about your child. This is a group practice with a very caring multidisciplinary team. Dr. Gbadegesin is rated as an Elite provider by MediFind in the treatment of Nephrotic Syndrome. His top areas of expertise are Focal Segmental Glomerulosclerosis, Nephrotic Syndrome, Minimal Change Disease, Glomerulonephritis, and Kidney Transplant.
Cleveland Clinic Main Campus
John Sedor is a Nephrologist in Cleveland, Ohio. Dr. Sedor has been practicing medicine for over 51 years and is rated as an Elite provider by MediFind in the treatment of Nephrotic Syndrome. His top areas of expertise are Minimal Change Disease, Nephrotic Syndrome, Focal Segmental Glomerulosclerosis, Glomerulonephritis, and Kidney Transplant.
The outcome varies. Some people recover from the condition. Others develop long-term kidney disease and need dialysis and eventually a kidney transplant.
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
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.
Treating conditions that can cause nephrotic syndrome may help prevent the syndrome.
Summary: This is a parallel, Phase 2a, double-blind, 6-arm study for the treatment of primary focal segmental glomerulosclerosis (FSGS) or primary minimal change disease (MCD). The purpose of this study is to measure the change in proteinuria and its impact on the rates of remission of nephrotic syndrome with frexalimab, SAR442970, or rilzabrutinib compared with placebo in participants with primary FSGS or...
Summary: Long-term glucocorticoids therapy is associated with various complications, including decreased bone strength (Glucocorticoid-induced osteoporosis) and an increased risk of fracture. Vitamin K2 has been recently deemed appreciable as a topic of research as it plays a pivotal role in maintenance of the bone strength, and it has been proved to have a positive impact on the bone metabolism. This stud...
Published Date: August 28, 2023
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 C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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.
Radhakrishnan J, Stokes MB. Glomerular disorders and nephrotic syndromes. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 107.
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.