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Nephrotic syndrome

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Nephrotic syndrome is a non-specific kidney disorder. It is caused when the small blood vessels that filter waste products and water become damaged and are unable to function efficiently. The function of these small vessels in a healthy kidney is to keep proteins from seeping into urine and out of your body. If these vessels are damaged, large amounts of these valuable proteins can be lost, and the body can react by swelling.

NEPHROTIC SYNDROME SYMPTOMS

Some of the symptoms of nephrotic syndrome can include swelling, especially around the eyes, ankles, and feet. You may also experience foamy urine, which can be a sign of too much protein. Other symptoms include weight gain, because of the fluid and swelling, loss of appetite, and vomiting. You may also experience serious side effects such as pleural effusion, high blood pressure, and problems with the liver.

NEPHROTIC SYNDROME CAUSES

Several different causes have been identified for nephrotic syndrome. Damage to the small vessels, or glomeruli, can usually be traced to one of the following conditions:
 Minimal change disease. This is the most common cause of this disorder in children. In children it results in abnormal kidney function, but is often deceiving because tissue samples look normal or nearly normal under a microscope. When this disorder is the cause of nephrotic syndrome, doctors are often unable to discern its cause.
 Focal segmental glomerulosclerosis. When this disorder occurs, the glomeruli are scarred, which prevents them from working efficiently. The scarring might be caused by genetic factors, the presence of another disease, or for no discernible reason.
 Membranous nephropathy. In this disorder, the membranes inside the glomeruli thicken, making it difficult for them to filter properly. This thickening is thought to be caused by several different problems, including hepatitis B, malaria, lupus, and cancer.
 Systemic lupus erythematosus. This is a chronic inflammatory disease, and can lead to serious damage of the kidneys.
 Diabetic kidney disease. Diabetic nephropathy, or kidney damage, is particularly common in poorly controlled diabetes or in people who have high blood pressure.
 Amyloidosis. This is a disorder that occurs when amyloid proteins accumulate in the organs. This build-up damages the kidneys’ filtering system.

Certain people are more at risk for nephrotic syndrome than others. Men are more likely to have it then are women. In addition, if you have diabetes, lupus, amlyloidosis, minimal change disease, or any other kidney disease, you are at higher risk.

NEPHROTIC SYNDROME DIAGNOSIS

You should contact your doctor if you experience foamy toilet water when you urinate, swelling around your eyes, ankles and feet, weight gain, or loss of appetite, with vomiting. Your doctor is likely to order a urine test, which will show if large amounts of protein have leaked into your urine. Another sign that a urine test will show is fats in the blood, which also result from a nephrotic leak. If the urine test is positive, your doctor will then order blood tests. These will show whether you have low levels of albumin in your blood, which will be the result of that protein leaking out of your urine. If you are losing albumin, you may also show an increase in cholesterol and triglycerides. If these two tests show a serious problem in protein levels, your doctor may order a kidney biopsy. This test examines a piece of your kidney tissue and attempts to identify what disorders in the kidneys may be causing your nephrotic syndrome.
nephrotic syndrome
Image: Nephrotic Syndrome

NEPHROTIC SYNDROME COMPLICATIONS

Several complications could arise for those who suffer form nephrotic syndrome.
 If blood isn’t being properly filtered and blood proteins are being lost, that could mean that proteins that help prevent clotting are being lost, which puts you at higher risk for blood clots. Blood clots, of course, are responsible for serious conditions such as stroke, heart attack, and pulmonary embolism.

 You may also have elevated cholesterol and triglycerides, which impacts your total health.
 If you lose too much blood, you may end up malnourished, which can lead to unhealthy weight loss. Unfortunately, it is sometimes difficult to identify this weight loss because of the swelling that often occurs.
 Because there is build up in your veins of substances that should flow through freely, you might experience a build-up of blood pressure.
 If your kidneys can’t filter blood, waste products may build up at a dangerous level, causing you to require emergency dialysis.
 If this happens frequently, or if it gets worse over time, kidneys may require constant dialysis or even a kidney transplant.
 You could be at higher risk for an infection in any other part of the body.

NEPHROTIC SYNDROME TREATMENT

It is most common to treat nephrotic syndrome by treating the underlying condition that caused it. In addition to those, there are other methods your doctor may recommend to treat the nephrotic syndrome itself.
 Your doctor may prescribe an ACE-inhibitor (or angiotensin-converting enzyme inhibitor) to reduce the amount of protein in your urine so that your kidney disorders do not becomes worse.
 A diuretic may increase your body’s output of water and help decrease the swelling.


 Statins can help lower elevated cholesterol levels.
 Blood thinners can decrease your risk of developing blood clots.
 Immunosuppressive medications can decrease the inflammation that you might be experiencing.
 Antibiotics can control infections.

NEPHROTIC SYNDROME PREVENTION

The most important preventative measures you can take to avoid the serious complications of nephrotic syndrome are to maintain your general health. If you maintain your weight at healthy levels, for example, you may be less likely to suffer the complications of diabetes. You should limit your intake of salt and sodium, which will help keep swelling at a minimum, and you can decrease your cholesterol and triglyceride intake, since these will be higher for those with nephrotic syndrome. Another preventative measure you can take is to take vitamin D supplements. If you suspect that you have any kidney problems, or you display any of the side effects listed above, you should contact your doctor immediately; early detection and treatment can help keep this from becoming a life threatening disease.
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