What is Nephrotic Syndrome?

Karyn Maier

Nephrotic syndrome is a form of chronic kidney disease that is characterized by fluid retention and swelling (edema), high serum cholesterol levels, high serum levels of albumin (hypoalbuminemia), and excessive amounts of protein in the urine (proteinuria). The latter is the most significant indication that nephrotic syndrome is present. This symptom is also one of the most significant adverse health affects since patients can be depleted of protein at a rate 25 times than normal in a single 24-hour period. In addition, this disorder is often responsible for near-end kidney disease and renal failure.

Advanced nephrotic syndrome may require dialysis treatment.
Advanced nephrotic syndrome may require dialysis treatment.

There are several underlying causes that can lead to the development of nephrotic syndrome, such as focal segmental glomerulosclerosis (FSGS), a genetic disorder that attacks the renal glomeruli and impairs the ability of the kidneys to filter impurities. Minimal change disease, sometimes triggered by certain medications or food allergies, is the leading cause of nephrotic syndrome in young children. Unfortunately, the particular difficulty in determining the latter lies in the fact that the kidney tissue often appears normal. Other secondary causes of this disease include diabetes, cancer and HIV infection. The rate of incidence is higher in men than women.

Elevated protein in the urine can be confirmed by a urinalysis.
Elevated protein in the urine can be confirmed by a urinalysis.

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There are also a number of secondary complications associated with nephrotic syndrome. For one thing, the buildup of metabolic waste and protein in the bloodstream can lead to uremia, a condition that promotes toxicity, the formation of blood clots, and an increase in blood pressure. For reasons largely unknown, nephrotic syndrome patients are also more susceptible to infections. In addition, the disease may eventually cause complete kidney failure, necessitating dialysis or organ transplant.

In terms of diagnosis, elevated levels of protein in the urine can be confirmed by urinalysis. The urgency for this test is often prompted by the appearance of foam or froth in the urine. Blood tests may be performed to check levels of albumin, the water-soluble protein that causes hypoalbuminemia in excess cicrulation. In addition, it may be necessary to biopsy or stain tissue samples from the kidneys to check for scarring of the glomeruli that may have been caused by FSGS.

Conventional treatment of nephrotic syndrome consists of medications to manage its complications, in addition to regular monitoring of proteins and fluids. Edema is typically addressed with diuretic medications. Proteinuria may be checked with the use of an angiotensin-converting enzyme inhibitor (ACE) or angiotensin II receptor blocker (ARB), which also help to reduce blood pressure. High cholesterol may be treated with various statin drugs. Oral corticosteroids, such as prednisolone, may also be administered to control tissue inflammation.

The kidneys and renal veins and arteries.
The kidneys and renal veins and arteries.

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