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A kidney condition known as nephrotic syndrome makes your body excrete excessive amounts of protein in urine.
Nephrotic syndrome, a condition that damages the clusters of tiny blood capillaries in the kidneys known as glomeruli, can have various consequences.
The glomeruli in your kidneys play a crucial role in filtering waste and excess fluids from your blood, which are then excreted as urine. They effectively remove various waste products, including nitrogen waste (urea), muscle waste (creatinine), and acids.
In a healthy state, the glomeruli efficiently filter out these waste products while ensuring that essential components like cells and proteins necessary for normal bodily functions are retained in the bloodstream.
However, when the glomeruli are damaged, they can no longer effectively perform their filtration function. This can result in blood proteins leaking into the urine, which is not typical in a healthy kidney.
It often leads to swelling, particularly in the ankles and feet increases the risk of developing additional health problems. Nephrotic syndrome is a life threatening condition. Without treatment, its complications may shorten your life expectancy.
It is not common to have nephrotic syndrome. Every year, roughly 1 in 50,000 kids develop nephrotic syndrome. Nephrotic syndrome is commonly diagnosed in children within the age range of 2 to 5 years old. In comparison to girls, boys are nearly twice as likely to have nephrotic syndrome. Every year, 3 out of every 100,000 adults experience it.
Treating the underlying condition causing nephrotic syndrome is essential, and it often involves medication. Having nephrotic syndrome increases the risk of infections and blood clots. To prevent these complications, your doctor may recommend a combination of medications and dietary modifications.
Symptoms
Nephrotic syndrome symptoms and signs include:
- Severe edema, especially in the ankles and feet and around the eyes
- Foamy pee, which is a symptom of too much protein in your urine
- Increased weight from fluid retention
- Blood fat and cholesterol levels that are increased
- Abdominal pain
- Exhaustion
- Loss of appetite
If you notice any symptoms or signs that raise concerns, it is important to schedule a consultation with your doctor. Promptly seeking medical attention is crucial when experiencing any worrisome symptoms related to nephrotic syndrome or any other health condition. By scheduling a consultation, you can discuss your concerns with your doctor and receive appropriate evaluation and guidance.
Causes
Damage to your kidneys’ glomeruli, which are collections of tiny blood vessels, is typically what causes nephrotic syndrome.
As your blood flows through your kidneys, the glomeruli filter it, separating the substances your body needs from those it doesn’t. Blood protein, primarily albumin, which is necessary to maintain the proper level of fluid in your body, is prevented from leaking into your urine by healthy glomeruli. Nephrotic syndrome occurs when the glomeruli are damaged, causing an excessive loss of blood proteins from the body.
Possible causes of nephrotic syndrome
Nephrotic syndrome can be brought on by a number of diseases and conditions, such as:
- Diabetic kidney disease. Diabetes can cause diabetic nephropathy, which affects the glomeruli and damages the kidneys.
- Minimal change disease. In children, this is the most typical cause of nephrotic syndrome. Minimal change disease causes aberrant kidney function. The cause of the abnormal function is often difficult to determine. However, when the kidney tissue is viewed under a microscope, it seems normal or nearly normal.
- Focal segmental glomerulosclerosis. This condition, which is characterized by scarring of portions of the glomeruli, can be brought on by another illness, a genetic abnormality, specific drugs, or it can develop for unknown reasons.
- Membranous nephropathy. Thickened membranes within the glomeruli are the cause of this kidney condition. The thickening is a result of deposits made by the immune system. It can happen for no apparent cause or it can be linked to other illnesses such cancer, hepatitis B, malaria, and lupus.
- Systemic lupus erythematosus. This autoimmune disease can cause inflammation throughout your body. It also has the potential to seriously damage the kidneys.
- Amyloidosis. Amyloid protein buildup in your organs causes this illness. An accumulation of amyloid frequently harms the kidneys’ filtration abilities.
Risk factors
Nephrotic syndrome risk factors include the following:
- Medical conditions that can damage your kidneys. Nephrotic syndrome is more likely to occur in people who have certain illnesses and conditions, such as diabetes, lupus, amyloidosis, reflux nephropathy, and other renal diseases.
- Medications. Nonsteroidal anti-inflammatory drugs and medications used to treat infections are among the substances that could lead to nephrotic syndrome.
- Infections. HIV, hepatitis B, hepatitis C, and malaria are among the infections that raise the chance of developing nephrotic syndrome.
Diagnosis
Various tests and procedures are employed to diagnose nephrotic syndrome. These include:
- Urine examination. A urinalysis can detect irregularities in your urine, like high protein levels. Urine samples may need to be collected throughout the course of a day (24-hour urine collection).
- Blood tests. A blood test may reveal low levels of the albumin protein as well as lower overall blood protein levels. A decrease in albumin is frequently accompanied by a rise in blood triglycerides and cholesterol. To determine how well your kidneys are functioning generally, your blood may also be tested for levels of urea nitrogen and creatinine.
- Kidney biopsy. Your physician might advise taking a tiny sample of kidney tissue for analysis. A needle is introduced into your kidney during a kidney biopsy through your skin. A collection of kidney tissue is sent to a lab for analysis.
Treatment
As part of the treatment for nephrotic syndrome, it is crucial to address any underlying medical conditions that might be contributing to the disease. Additionally, your doctor may recommend specific medications and dietary modifications to help manage the signs and symptoms, and complications of nephrotic syndrome. Medications could consist of:
- Blood pressure medications. Angiotensin-Converting Enzyme (ACE) inhibitors are medications that lower blood pressure and the volume of protein excreted in the urine. Lisinopril, benazepril, captopril, and enalapril are medications that fall under this group.
Losartan and valsartan are part of the class of medications known as angiotensin II receptor blockers (ARBs) that share a similar mechanism of action. Although ACE inhibitors and ARBs are typically used first, other drugs, such as renin inhibitors, may also be utilized.
- Diuretics. By increasing your kidneys’ fluid output, these reduce edema. Furosemide is a common diuretic drug. Spironolactone and thiazides, such as hydrochlorothiazide or metolazone, are some more options.
- Cholesterol-reducing medications. With statins, cholesterol levels can be reduced. It is unclear, though, if cholesterol-lowering drugs can help nephrotic syndrome patients achieve better results, such as reducing their chance of developing heart attacks or early death.
Atorvastatin, fluvastatin, lovasatin, pravastatin, rosuvastatin, and simvastatin are statins.
- Anticoagulants. Particularly if you’ve already experienced a blood clot, these may be given to lessen your blood’s propensity to clot. Heparin, warfarin, dabigatran, apixaban, and rivaroxaban are anticoagulants.
- Immune system-suppressing medications. Certain disorders that may lead to nephrotic syndrome are associated with inflammation, which can be alleviated using immune system-regulating drugs. Corticosteroids are commonly prescribed to reduce inflammation in these cases. Additionally, medications such as rituximab, cyclosporine, and cyclophosphamide may be used to manage nephrotic syndrome. These drugs help modulate the immune response and control the underlying inflammatory processes. By incorporating these medications into the treatment plan, healthcare professionals aim to mitigate inflammation and improve the overall management of nephrotic syndrome.
