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.