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Nephrotic syndrome – Symptoms, Causes, Treatment

Updated on December 19, 2013

What is Nephrotic Syndrome?

Nephrotic syndrome is a condition of the kidney which leads to the excretion of excessive protein in the urine.

The kidneys contain a bunch of tiny blood vessels that clear the unwanted water and waste from the blood. Nephrotic syndrome is generally caused due to damage of these blood vessels. It results in inflammation or edema, especially in the ankles and the feet, in addition to many other health complications.

Nephrotic syndrome is usually treated with the aid of drugs as well as treatment of the preexisting condition that is causing the disorder. The increased risk to blood clots and infections due to nephrotic syndrome is also looked into, and additional steps may be recommended by the doctor to prevent them.

Symptoms of Nephrotic Syndrome

Some of the signs and symptoms of nephrotic syndrome include the following:

  • The urine may have a foam-like appearance due to the presence of excess protein in the urine
  • The ankles, feet and other parts of the body may experience swelling or edema
  • The person affected by nephrotic syndrome may gain weight due to additional fluid retention

Nephrotic syndrome may lead to the development of a number of complications. Some of them are discussed below:

  • There is severe loss of proteins from the blood due to the incapability of the blood vessels in the kidneys to properly filter blood. These proteins play an important role in the prevention of blood clotting, and hence their loss can increase the risk to developing a blood clot in the veins.
  • The loss of excess protein can also result in loss of essential nutrition which can lead to weight loss. However, one may not notice weight loss due to swelling
  • Extensive damage to the blood vessels in the kidneys, due to nephrotic syndrome, can cause the kidneys to lose their capability to clear blood. This can result in rapid buildup of waste and excess fluids in the blood, which then need to be eliminated via an emergency dialysis.
  • The fall in the levels of protein albumin in the blood causes the liver to produce more albumins. Due to this action, additional amounts of triglycerides and cholesterol are also released by the liver at the same time, causing their levels to become very high.
  • Nephrotic syndrome increases the risk to infections
  • The accumulation of waste in the blood can result in elevated levels of blood pressure
  • Nephrotic syndrome can also result in chronic kidney failure over a period of time. Such a condition would then require a kidney transplant or a dialysis

Causes of Nephrotic Syndrome

When the group of small blood vessels in the kidneys known as glomeruli is damaged, then it leads to the development of nephrotic syndrome.

The glomeruli perform the function of filtering the blood when it goes through the kidneys and eliminates the waster and excess water not needed by the body. The levels of blood protein, particularly albumin, are maintained by functioning glomeruli by preventing the passing of excess protein into the urine. Damaged glomeruli are unable to perform this vital function, which results in the development of nephrotic syndrome

The blood vessels in the kidney can get damaged due to a number of reasons. Some of them are listed below:

  • A condition known as minimal change disease is the primary cause of nephrotic syndrome in children. The condition causes the kidneys to function abnormally. The causes of minimal change disease are not known.
  • Nephrotic syndrome is also caused due to the presence of membranous nephropathy, which is a kidney abnormality caused due to thickening of the membranes inside the blood vessels of the kidneys. The exact cause of membranous nephropathy is unknown, but is believed to result from other conditions such as lupus, hepatitis B, cancer and malaria.
  • Nephrotic syndrome can also develop due to a few types of cardiac failure such as extreme right heart failure and constrictive pericarditis
  • A condition known as focal segmental glomerulosclerosis which causes strewn scarring of some of the blood vessels in the kidneys, can also result in nephrotic syndrome
  • Diabetes that leads to kidney and glomeruli damage can also cause nephrotic syndrome
  • Amyloidosis is a condition which causes excessive buildup of amyloid proteins in various organs. When amyloidosis affects the kidneys, then it damages it causing nephrotic syndrome
  • The development of blood clots in any of the veins in the kidneys due to certain conditions such as renal vein thrombosis, can result in nephrotic syndrome

Treatment of Nephrotic Syndrome

There is no standard procedure to treat nephrotic syndrome. The treatment focuses on curing the underlying condition that has caused nephrotic syndrome as well as management of the various complications, signs and symptoms associated with the condition. Treatment includes:

Medications such as:

  • Blood pressure drugs to reduce the blood pressure and also to decrease the quantities of protein passed into urine.
  • Medications to reduce cholesterol levels
  • Diuretics to alleviate the swelling
  • Corticosteroids and other medications to suppress the immune system
  • Blood thinning drugs to decrease the risk to blood clots

Changes in diet:

  • To reduce the levels of cholesterol
  • To consume lean sources of protein
  • To intake low-salt food items

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