Nephrotic Syndrome

Nephrotic syndrome is an abnormality in the kidneys, which cause the body to pass excessive amounts of protein in the urine. Typically caused by a kidney damage, particularly in the small blood vessels, nephrotic syndrome makes it difficult for the organ to filter waste and water properly. Hence, the disorder may cause edema and other complications, such as infections and blood clots. 

Nephrotic syndrome is treated by treating the underlying conditions first. If you have possible kidney disease, your doctor will prescribe the proper medications and advise you to change your diet to prevent further damage and minimize the risk of having complications.

The symptoms of having nephrotic syndrome are:

• Edema or severe swelling, particularly on the feet and area around the eyes
• Foamy urine, which is a sign of excess protein
• Sudden, unexplainable weight gain that may be caused by fluid retention

Nephrotic syndrome is usually caused by damage to the clusters of tiny blood vessels (glomeruli) of your kidneys.

The glomeruli is the clusters of tiny blood vessels that filter the blood passing the kidneys and acting like a sieve that separates things that the body needs and doesn’t. 

Damaged glomeruli allows excessive protein to pass your urine, which is basically an abnormal function.

Many diseases and health conditions are known to damage the glomeruli, thus leading to nephrotic syndrome. These conditions include:

• Minimal change disease. Since it allows abnormal kidney function, minimal change disease is one of the underlying causes of nephrotic syndrome, especially in children.
• Focal segmental glomerulosclerosis. This condition is usually caused by a genetic defect or as a complication of other diseases and characterized by scarring of the glomeruli.
• Membranous nephropathy. This is a kidney disorder that results in abnormally thicker glomerular membranes. While the exact cause of it is still unknown, experts associate it with some serious medical conditions like hepatitis B, lupus, malaria, and cancer.
• Diabetic kidney disease. Diabetic nephropathy or kidney damage due to diabetes complications can have undesirable impact to the glomeruli.

Apart from the serious health conditions mentioned, Amyloidosis, renal vein thrombosis, and even heart failure can result in nephrotic syndrome.

If you think you have the signs and symptoms of nephrotic syndrome, see your doctor immediately to receive a diagnosis. If your doctor think it is indeed connected to your kidneys, he or she may refer you to a nephrologist, or a doctor specializing in kidneys. 

Here are what you can do to make you ready for the appointment:

• When making an appointment, ask the assistant if there is anything you have to do or not do prior the check up. 
• List down your symptoms. This will keep you from forgetting important details.
• Write down recent changes in your life, including the reasons of your stress, if there are any.
• List down the medications and supplements you have been taking.
• If there’s anything you want to ask the doctor, write them down, as well. Preparing this list ahead of time can help maximize your check-up time. 

During the visit, your doctor may require certain tests and procedures to be done. Most of the time, the following are done to diagnose nephrotic syndrome:

• Urinalysis: A urine test is done to see if there are abnormalities in your urine. In diagnosing nephrotic syndrome, the urine is checked for excessive counts of urine.
• Blood tests: To help rule out nephrotic syndrome, protein levels in the blood is checked. If your blood tests show that your protein albumin is low, you may possibly have nephrotic syndrome. Blood urea and serum creatinine are sometimes checked as well, in order to asses the overall function of the kidneys.
• Tissue testing: Your doctor may ask your permission to remove a sample of your kidney tissue for further testing. This is done by inserting a special needle through the skin and into the kidney. The needle collects samples of kidney tissue for laboratory testing. 

If you have nephrotic syndrome, the treatment course usually involves treating possible underlying conditions. Moreover, your doctor may recommend drugs to keep your symptoms under control and treat the complications. 

The following are the common medication for nephrotic syndrome:

• Angiotensin-converting enzyme inhibitors: These medications keep the blood pressure in normal levels and reduce the protein in urine, as well. Benazepril, captopril, and enalapril are usually prescribed.
• Angiotensin II receptor blockers: These drugs work like the Angiotensin-converting enzyme inhibitors. Common drugs like losartan and valsartan fall in this group.
• Diuretics: Also called as water pills, diuretics help flush out excess water by increasing the fluid output of the kidneys. Furosemide and spironolactone are commonly-known diuretics. 
• Cholesterol-reducing medications: Statins, or medications that reduce cholesterol levels, are sometimes used in patients with nephrotic syndrome. These drugs include atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, and simvastatin. 
• Blood thinners: Anticoagulants or blood thinners minimize the risk of developing blood clots. Heparin and warfarin are known anticoagulants. 
• Immune system-suppressing drugs: These are taken to reduce the risk of inflammation that usually come with most kidney disorders.

By changing your lifestyle and diet, you can help your body cope with nephrotic syndrome and its complications. A dietitian can help you learn the right food to eat to minimize your complications and alleviate your symptoms. 

Reducing cholesterol and fat intake can keep your blood cholesterol and blood pressure levels from shooting up. A low-salt diet, on the other hand, can help control edema or swelling. 

There are several risks and complications associated with nephrotic syndrome.

Your risk of getting nephrotic syndrome increases greatly with these factors:

• Kidney-damaging medical conditions: Lupus, diabetes, minimal change disease, amyloidosis, and other kidney diseases can damage the kidneys and increase your risk of developing this syndrome.
• Certain medications: Non-steroidal anti-inflammatory drugs (NSAIDS) and certain anti-infection drugs can damage the kidneys, thus increasing your risk of nephrotic syndrome.
• Serious infections: Infections that elevate your risk of complications include hepatitis B and C, malaria, and HIV.

Nephrotic syndrome, if not managed well, can cause a number of complications, including:

• blood clots,
• poor nutrition,
• high blood pressure,
• acute kidney failure,
• chronic kidney disease,
• infections.