NEPHROTIC SYNDROME

(Nephrosis)

 Basic information

description

Nephrotic syndrome is a condition that results from damage to tiny blood vessels in the kidneys called glomeruli. Normally, the glomeruli filter the waste and excess water from blood and into urine. When they are damaged, they do not filter properly. This causes substances (proteins) to leak out of the blood and into the urine, which then leads to fluid building up in the tissues and swelling (edema). Nephrotic syndrome affects all age groups, but is more common in children.

FREQUENT SIGNS & SYMPTOMS

• Fluid retention (edema). At first, it causes puffy eyes and ankles, which is followed by general puffiness of the skin, and then, a swollen abdomen.
• Weight gain due to fluid retention.
• Reduced urine output (as low as 20% of normal).
• Appetite loss, weakness, and general ill feeling.
• Frothy (foamy) urine.

causes

The cause of the kidney damage is often unknown. It may be due to numerous underlying disorders. In children, it is often due to a kidney disorder called minimal change disease.

risk increases with

• Disorders that affect kidney function. These include diabetes, lupus erythematosus, cancers, glomerulonephritis, autoimmune disorders, serum sickness and other severe allergic disorders, blood clot in the kidney, numerous types of infections, sickle cell anemia, congenital heart disease, severe high blood pressure, other disorders, and drugs that are toxic to the kidneys.
• Weak immune system due to illness or drugs.
• Family history of renal failure.
• Exposure to some chemical toxins or illegal drug use.

PREVENTIVE MEASURES

• Getting treatment for any risk factor listed may help.
• Drugs may be prescribed to help prevent nephrotic disorder in persons at risk.

expected outcomes

The outcome will depend on the underlying cause diagnosed. If it is treatable, such as an infection, the outcome is often good. In children with minimal disease, almost all patients respond to treatment. In other cases, the outcome may be less favorable and kidney failure and other complications may occur.

possible complications

Infections, kidney failure, blood clots, high blood pressure, failure to thrive in children, poor nutrition, high blood-fat levels, heart problems, or fluid overload.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask about your symptoms and activities. Medical tests may include urine and blood studies. A kidney biopsy may be done to diagnose any kidney disorder. A biopsy involves removal of a small amount of kidney tissue or fluid for viewing under a microscope.
• Treatment will be prescribed for any underlying disorder diagnosed or to relieve the symptoms of nephrotic syndrome. Treatment is usually with drugs and sometimes with diet changes.
• To learn more: National Kidney Foundation, 30 E. 33rd St., Suite 1100, New York, NY 10016; (800) 622-9010; website: www.kidney.org.

medications

• Your health care provider may prescribe:
  • Cortisone or immunosuppressive drugs.
  • Diuretics to reduce fluid retention.
  • Drugs to treat infections.
  • Angiotensin-converting enzyme (ACE) inhibitors to reduce protein loss.
  • Drugs for high blood pressure or high cholesterol.
  • Anticoagulants for blood clots.
  • Stopping the use of any drug that is the cause.

activity

After the swelling decreases, be as active as your strength and health condition allows.

diet

You will be advised about any limits on fat, salt, protein, and fluid intake, depending on your individual case.

 notify our office if

• You or a family member has symptoms of nephrotic syndrome.
• Chest pain or shortness of breath or severe stomach pain occur. Seek emergency help.
• Signs of infection occur (e.g., fever, headache, nausea or vomiting, diarrhea, or burning during urination).
• Sudden swelling, bloody urine, sudden weight gain, or other symptoms develop that cause concern.

Special Notes: