Nephrotic Syndrome - What Is Nephrotic Syndrome?

Kidney Health Care - David Mangusan Jr, PTRP

Nephrotic syndrome is a type of kidney disease marked by elevated levels of protein in the urine, a condition called proteinuria; low levels of protein in the blood; swelling, especially around the eyes, feet, and hands; and high cholesterol. It occurs when the kidneys' glomeruli are damaged. The glomeruli are tiny blood vessels in the kidneys that filter wastes and excess water from the blood.

Causes

Normal glomeruli help keep protein in the blood from leaking into the urine. If the kidneys are healthy, they allow less than 1 gram of protein to escape through the urine per day. In nephrotic syndrome, however, the damaged glomeruli allow 3 grams or more of protein to leak into the urine during a 24-hour period.

Because of protein loss, the blood becomes deficient of the substance. The body needs normal amounts of protein in the blood to function properly. Blood proteins help in regulating fluid throughout the body. It does this by acting as sponge to soak up fluid into the bloodstream.

Lack of proteins in the blood causes fluid to accumulate in the body's tissues instead of circulating through the blood. This can then result in swelling and puffiness.

Common causes of nephrotic syndrome in adults are diabetic nephropathy, membranous nephropathy, and amyloidosis. In most cases, however, the cause of the disease is unknown.

Treatment

It is important for a doctor to know the cause of nephrotic syndrome through several tests.

In addition to addressing the underlying cause, treatment of nephrotic syndrome focuses on reducing high cholesterol, blood pressure, and protein in urine through diet, medications, or both. Two groups of blood pressure medications—angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs)—also protect the kidneys by reducing proteinuria.

Some people may benefit from limiting protein in their diet to reduce the buildup of wastes in the blood.

Nephrotic syndrome may go away once the underlying cause, if known, has been treated. In adults, most of the time the underlying cause is a kidney disease such as membranous nephropathy or focal segmental glomerulonephritis, diseases that are treated with corticosteroids, immunosuppressive drugs, and, in some cases, cytotoxic agents. Unfortunately, these treatments do not always bring about remission of nephrotic syndrome.

Depending on the disease, as many as half of the patients, according to the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), may develop chronic kidney disease that progresses to end-stage renal disease. In these cases, the kidneys gradually lose their ability to filter wastes and excess water from the blood. If kidney failure occurs, the person will need dialysis or a kidney transplantation.

Related Topics:

Sources:
Nephrotic Syndrome in Adults, NKUDIC, NIDDK Website.

Glomerular Diseases, NKUDIC, NIDDK Website.

Page Last Revised: February 26, 2011

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