Nephrotic syndrome is a kidney disorder that causes the body to over excrete protein into the urine (proteinuria) due to damage to small vessels (glomeruli) in the kidney. They become leaky and edema (excess fluid in the body tissues) develops.
In general, any problem, drug, disease, or genetics that cause or allow damage to the glomeruli of the kidney can cause nephrotic syndrome. Primary causes include kidney diseases like membranous nephropathy and focal glomerulosclerosis. Secondary causes include diabetes, lupus, amyloidosis, and heroin use. Mutations of genes that code for several proteins (for example, congenital and hereditary focal glomerulosclerosis) in kidney cells may also cause the disease. Nephrotic syndrome can be of several types: acute (kidney injury), chronic (genetic cause), idiopathic (unknown cause), steroid sensitive or resistant, and types that frequently relapse.
Risk factors for nephrotic syndrome include diabetes, high blood pressure, family history of the disease, age over 60, race/ethnicity (African, Native, Asian, and Hispanic Americans), polycystic kidneys, kidney cancer, autoimmune diseases, acute kidney trauma, and drugs or any cause that leads to glomerulonephritis (a form of kidney inflammation).
The first sign of nephrotic syndrome in children is swelling of the face. In adults, it can be dependent edema. The signs and symptoms of nephrotic syndrome may include the following:
The usual first test done is dipstick urinalysis to determine the approximate amount of protein present in the urine. A 3+ result indicates the level of protein present in urine is in the nephrotic syndrome range. Other tests (sediment exams, albumen levels in the blood, biopsy of kidneys, for example) may be done to help determine any underlying causes. Children may have genetic testing done.
The aim of treatment of nephrotic syndrome focuses on reducing symptoms and treating any underlying causes. Doctors may administer or prescribe the following types of medications:
Medical professionals administer medications on an individual basis and are best determined by your medical condition and your medical caregivers.
Most home remedies for nephrotic syndrome are based on diet considerations that may reduce symptoms of edema. Choosing lean (low fat and low cholesterol) sources of protein, a low-salt diet, and limiting foods high in glucose may be helpful. Some recommend zinc supplements, but people should consult their doctors before using them.
Complications of this syndrome include the following:
Infants with the disease have a poor prognosis; survival is possible with dialysis and kidney transplant. Those with acute disease have a good prognosis if the underlying causes can be treated. Those with chronic disease have a more guarded prognosis especially if they develop complications.
It may be possible to prevent some types of the disease by stopping the underlying cause (prevention of kidney trauma, avoiding heroin use) while it's impossible to prevent the other types (genetic cause). In general, if it's possible to prevent the underlying cause, it's possible to prevent the disease.
The organs of the abdomen are contained in a sac or membrane called the peritoneum. Normally the peritoneal cavity contains only a small amount of fluid, although in women this can vary (by 20 ml, or less than an ounce) depending on the menstrual cycle. Ascites is the term used to denote increased fluid in the peritoneal cavity, a situation that is not normal.
