Nephrotic syndrome (nephropathy for short) is caused by a large number of loss of plasma proteins from urine due to the increased permeability of glomerular filtrating membrane, clinically marked by heavy proteinuria, hypoproteinemia, hypercholesteremia and obvious edema. Primary nephropathy can be subdivided into simple nephropathy and nephritic nephropathy. This section mainly discusses the primary nephropathy.
Alternative Names of Nyphrotic Syndrome are: Nephrosis
Complications of Nyphrotic Syndrome
Possible complications of nephrotic syndrome include:
Blood clots. The inability of the glomeruli to filter blood properly can lead to loss of blood proteins that help prevent clotting. This increases your risk of developing a blood clot (thrombus) in your veins.
High blood cholesterol and elevated blood triglycerides. When the level of the protein albumin in your blood falls, your liver makes more albumin. At the same time, your liver releases more cholesterol and triglycerides.
Poor nutrition. Loss of too much blood protein can result in malnutrition. This can lead to weight loss, but it may be masked by swelling.
High blood pressure. Damage to your glomeruli and the resulting buildup of wastes in your bloodstream (uremia) can raise your blood pressure.
Acute kidney failure. If your kidneys lose their ability to filter blood due to damage to the glomeruli, waste products may build up quickly in your blood. If this happens, you may need emergency dialysis - an artificial means of removing extra fluids and waste from your blood - typically with an artificial kidney machine (dialyzer).
Chronic kidney failure. Nephrotic syndrome may cause your kidneys to gradually lose their function over time. If kidney function falls low enough, you may require dialysis or a kidney transplant.
Infections. People with nephrotic syndrome have an increased risk of infections.
Causes of Nyphrotic Syndrome
Nephrotic syndrome is caused by various disorders that damage the kidneys, particularly the basement membrane of the glomerulus. This immediately causes abnormal excretion of protein in the urine.
The most common cause in children is minimal change disease, while membranous glomerulonephritis is the most common cause in adults.
This condition can also occur as a result of infection (such as strep throat, hepatitis, or mononucleosis), use of certain drugs, cancer, genetic disorders, immune disorders, or diseases that affect multiple body systems including diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis.
It can accompany kidney disorders such as glomerulonephritis, focal and segmental glomerulosclerosis, and mesangiocapillary glomerulonephritis.
Nephrotic syndrome can affect all age groups. In children, it is most common from age 2 to 6. This disorder occurs slightly more often in males than females.
Signs & Symptoms of Nyphrotic Syndrome
Swelling (edema) is the most common symptom. It may occur:
In the face and around the eyes (facial swelling)
In the arms and legs, especially in the feet and ankles
In the belly area (swollen abdomen)
Other symptoms include:
Foamy appearance of the urine
Weight gain (unintentional) from fluid retention
High blood pressure
Diagnosis of Nyphrotic Syndrome
Tests and procedures used to diagnose nephrotic syndrome include:
Urine tests. A urinalysis can reveal abnormalities in your urine, such as large amounts of protein, if you have nephrotic syndrome. You may be asked to collect urine samples over 24 hours for an accurate measure of the protein in your urine.
Blood tests. If you have nephrotic syndrome, a blood test may show low levels of the protein albumin (hypoalbuminemia) specifically and decreased levels of blood protein overall. Loss of blood protein may cause an increase in blood cholesterol and blood triglycerides. Serum creatinine and blood urea also may be measured to assess your overall kidney function.
Removing a sample of kidney tissue for testing. Your doctor may recommend a procedure called a kidney biopsy to remove a small sample of kidney tissue for testing. During a kidney biopsy, a special needle is inserted through your skin and into your kidney. Kidney tissue is collected and sent to a laboratory for testing.
Treatments of Nyphrotic Syndrome Treatment for nephrotic syndrome involves treating the underlying medical condition that's causing your nephrotic syndrome.
Your doctor may also recommend medications that may help control your signs and symptoms or treat complications of nephrotic syndrome. Medications may include:
Blood pressure medications. Drugs called angiotensin-converting enzyme inhibitors reduce blood pressure and also reduce the amount of protein released in urine. Medications in this category include benazepril (Lotensin), captopril (Capoten) and enalapril (Vasotec). Another group of drugs that works in a similar way is called angiotensin II receptor blockers and includes losartan (Cozaar) and valsartan (Diovan).
Water pills. Water pills (diuretics) help control swelling by increasing your kidneys' fluid output. Diuretic medications include chlorothiazide, hydrochlorothiazide, furosemide (Lasix) or spironolactone (Aldactone).
Cholesterol-reducing medications. Medications called statins can help lower cholesterol levels. Statins include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Altoprev, Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor).
Blood thinners. Medications called anticoagulants help decrease your blood's ability to clot and reduce your risk of developing blood clots. Anticoagulants include heparin or warfarin (Coumadin).
Immune-system-suppressing medications. Medications to control the immune system, such as corticosteroids, may decrease the inflammation that accompanies kidney disorders, such as membranous nephropathy.
Antibiotics. Antibiotics can help control infections caused by bacteria.
Prevention of Nyphrotic Syndrome
Appropriate treatment of conditions that can cause nephrotic syndrome may help prevent the syndrome.
When to seek Medical Advice
Call your doctor if symptoms which may indicate nephrotic syndrome occur.
Call your doctor if nephrotic syndrome persists or if new symptoms develop, including severe headache, fever, sores on the skin, cough, discomfort with urination, or decreased urine output.