Nephrotic Syndrome
What is nephrotic
syndrome?
Nephrotic syndrome causes scarring or damage to
the filtering part of the kidneys (glomeruli). This causes too much protein to
be lost from the blood into the urine.
People with nephrotic syndrome often have:
·
Very high levels of protein
in the urine (proteinuria)
·
Low levels of protein in the
blood (hypoalbuminemia)
·
Swelling (edema), especially
around the eyes, feet, and hands
·
High cholesterol
What causes nephrotic
syndrome?
Nephrotic syndrome results from damage to the
kidneys' glomeruli. These are the tiny blood vessels that filter waste and
excess water from the blood and send them to the bladder as urine.
Your glomeruli keep protein in the body. When
they are damaged, protein leaks into the urine. Healthy kidneys allow less than
1 gram of protein to spill into the urine in a day. In nephrotic syndrome, the
glomeruli let 3 grams or more of protein to leak into the urine during a
24-hour period.
Nephrotic syndrome may occur with other health
problems, such as kidney disease caused by diabetes and immune disorders. It
can also develop after damage from viral infections.
The cause ofnephrotic syndrome is not always
known.
What are the symptoms
of nephrotic syndrome?
Nephrotic syndrome is a set of symptoms. These
are the most common:
·
High blood pressure
·
Swelling in the feet and
hands, and around the eyes
·
Weight gain with fluid
retention and swelling
·
Signs of infection such as
fever, or an elevated white blood cell count
·
Swelling and pain related to
blood clots as the blood becomes thickened
·
Urine that appears foamy from
protein loss from the body into voided urine
The symptoms of nephrotic syndrome may look like
other medical conditions or problems. Always consult your health care
provider for a diagnosis.
How is nephrotic
syndrome diagnosed?
Your doctor will review medical history and do a
physical exam. Other tests may include:
·
Blood pressure checks
·
Measurement of your
cholesterol levels
·
Measurement of protein levels
in your urine and in the blood
·
Kidney biopsy (exam of a
sample of kidney tissue)
What is the treatment
for nephrotic syndrome?
Your health care provider will figure out the
best treatment based on:
·
How old you are
·
Your overall health and
medical history
·
How sick you are
·
How well you can handle
specific medications, procedures, or therapies
·
How long the condition is
expected to last
·
Your opinion or preference
Your doctor will try to find the underlying
cause. He or she will also attempt to control blood pressure and cholesterol,
and reduce protein in the urine.
Medicines can include:
·
ACE inhibitors and angiotensin receptor blockers (ARBs). These lower blood
pressure and may be used in people with diabetes to protect the kidneys.
·
Corticosteroids. These may be prescribed to reduce swelling and inflammation
within the glomerulus. They also help prevent your immune system from attacking
healthy tissue.
·
Diuretics. These are cautiously used to decrease the amount of swelling.
·
Immune system modifying medicines. These medicines are used to keep your immune system from
attacking the glomerulus.
·
Cholesterol-lowering medications. These may be prescribed if your triglyceride and cholesterol
levels are high.
·
Anticoagulants. These are blood thinning medicines and may be prescribed if
blood clots develop.
·
Antibiotics or antiviral medicines. These are used to treat the underlying infectious cause.
Diet. A special diet can help delay the need for
dialysis and to get rid of extra fluid and toxins that build up. Avoid salt to
prevent more swelling. Avoid fats and cholesterol. Be sure to eat lean protein.
Dialysis is used in extreme cases to remove fluid and
toxins when your kidneys have severely impaired filtering.
What are the
complications of nephrotic syndrome?
Serious complications of nephrotic syndrome
include kidney failure or end stage renal disease (ESRD). This requires
short-term or long-term dialysis. Blood clots and infection are other
complications. These occur due to the loss of protein in the urine
(proteinuria).
Can nephrotic
syndrome be prevented?
Not all causes of nephrotic syndrome can be
prevented. To prevent damage to the glomeruli:
·
Make sure your blood pressure
is well controlled.
·
If you have diabetes, make
sure your blood sugar is controlled.
·
Keep up-to-date with
vaccinations that help to prevent common infections. This is especially true if
you work or live around people who have hepatitis and other viral infections.
·
Finish all antibiotics as
prescribed. Do not stop your antibiotics because you may be feeling better.
And, don’t save them for a later date.
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