Nephrotic syndrome is caused by various disorders that damage the kidneys, especially the basement membrane of the glomerulus. This causes abnormal excretion of protein in the urine.
This condition can also occur as a result of infection, use of certain drugs, cancer, genetic disorders, immune disorders, or diseases that affect multiple body systems including diabetes, lupus, multiple myeloma, and amyloidosis
Nephrotic syndrome can affect all age groups. In children, it’s most common from age 2 to 6. This disorder occurs slightly more often in males than females.
The first symptom of nephrotic syndrome is often foamy urine. As it progresses, swelling is noticed in the eyelids, hands, feet, knees, scrotum, and abdomen. The person will feel weak and tired. Their appetite will decrease. The loss of protein causes the muscles to become weak and small. Because the kidneys are involved in blood pressure regulation, abnormally low or high blood pressure may develope.
Complications of nephrotic syndrome may include venous thrombosis which occurs in the renal veins. Infection is due to leakage of immunoglobulins, bacteria such as influenzae, and streptococcus. Acute renal failure, despite the excess fluid in the tissues, there is less in the vasculature. Decreased blood flow to the kidneys will cause them to shutdown. Pulmonary edema is due to fluid leak, which sometimes leaks into the lungs causing hypoxia and dyspenia. Growth retardation is due to protein deficiency from the loss of protein in urine. Vitamin D deficiency can occur also.
Over time, the protein loss will result in a generally malnourished state. Hair and nails become brittle, and growth is stunted. Bone becomes weak, and the body begins to lose other important nutrients like, (sugar, potassium, calcium).
Diagnosis is based on blood and urine tests and sometimes images of the kidneys, a biopsy of the kidneys, or both.
While the urine will reveal significant quantities of protein, the blood will reveal abnormally low amounts of circulating proteins, and high levels of cholesterol. In order to diagnose one of the kidney disorders which cause nephrotic syndrome, a biopsy will need to be examined. This biopsy can be done with a long, thin needle which is inserted through the skin under the ribs.
Treatment depends on the underlining disorder which caused nephrotic syndrome. Medications which dampen the immune system are a mainstay of treatment. The first choice is a steroid drug called prednisone. Some conditions may require more potent medications. Treating the underlying conditions which led to the syndrome will improve the symptoms as well.
The goal is to relieve symptoms, prevent complications and delay progressive kidney damage. Treatment may be required for life.
Treatment of nephritic syndrome focuses on reducing high cholesterol, high blood pressure, and protein in urine through diet, medications, or both. Some people may benefit from limiting protein in their diet to reduce buildup of wastes in the blood.
The outcome varies; the syndrome may be acute and short-term or chronic and unresponsive to therapy.
The prognosis depends on the underlying cause of nephrotic syndrome. It is usually good in children, because minimal change disease responds well to steroids and does not cause chronic renal failure. Minimal change disease has the best prognosis of all the kidney disorders, with 90% of all patients responding to treatment. Other types of kidney diseases have less favorable outcomes, with high rates of progression to kidney failure. When nephritic syndrome is caused by another treatable disorder the prognosis is very good.
Nephrotic syndrome can be prevented as long as a person goes to the doctor regularly and follows a regular diet plan. Making sure that their blood pressure stays within normal range, and protein levels are normal. Living a normal and healthy life will prevent this syndrome.
Sources: Right Health, Wikipedia, Medline Plus, Health Guide, Life Force,Healthatoz.com.