Nephrotic syndrome

Nephrotic syndrome is the medical term used to describe a collection of signs and symptoms. They occur because of kidney damage.^[1] This is different from nephritic syndrome where there are red blood cells in urine, giving it a red colour appearance.^[2]

Nephrotic syndrome is diagnosed by doctors based on the classical symptoms of oedema, proteinuria, hypoalbuminemia and hyperlipidaemia (which is explained below).

• Oedema - swelling of the body^[1]
• Proteinuria - lipids passing in urine
• Hypoalbuminemia - low albumin level in blood
• Hyperlipidaemia - high lipid level in blood
• Lipiduria - lipids passing in urine
• Hyponatremia - low sodium in blood
• Frothy urine

Causes can be divided into two as primary and secondary causes.^[3]

Primary causes are conditions developing within the kidney.

• Minimal change disease (MCD)
• Focal segmental glomerulosclerosis (FSGS)

Secondary causes affect other body parts in addition to kidneys.

• Diabetes
• Systemic lupus erythematosis (SLE)
• Vasculitis - inflammation of blood vessels

Treatment is with drugs that will reduce the damage to the kidneys. Prednisone, Cyclophosphamide, levamisole are some drugs used to treat nephrotic syndrome.^[4]

In addition to that lack of albumin is treated by giving albumin from outside into a vein. Fluid retention is treated with drugs called "diuretics" which will remove excessive water collected in the body. The person is advised to consume salt, fat containing foods and fluids including water in low amounts.^[5]

Prognosis is the medical term for the likely outcome of a disease. Good prognosis means the person will have a good outcome with no organ damage and no long lasting effects due to the disease.

Nephrotic syndrome in children usually has a good prognosis. However in children less than 5 years old and in adults over 30 years the prognosis is usually not good and can lead to permanent kidney damage. In these groups the disease will reappear after some time and need continuous drug treatment to keep the disease under control.^[6]

1. ↑ ^{1.0 1.1} "Nephrotic Syndrome in Adults | NIDDK". National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved 2020-09-23.
2. ↑ Ferri, Fred F. (2017-05-25). Ferri's Clinical Advisor 2018 E-Book: 5 Books in 1. Elsevier Health Sciences. ISBN 978-0-323-52957-0.
3. ↑ Kelly, Christopher R.; Landman, Jaime (2012-03-29). The Netter Collection of Medical Illustrations - Urinary System e-Book. Elsevier Health Sciences. ISBN 978-1-4557-2656-1.
4. ↑ Hahn, Deirdre; Hodson, Elisabeth M; Willis, Narelle S; Craig, Jonathan C (2015-03-18). "Corticosteroid therapy for nephrotic syndrome in children". The Cochrane Database of Systematic Reviews. 2015 (3): CD001533. doi:10.1002/14651858.CD001533.pub5. ISSN 1469-493X. PMC 7025788. PMID 25785660.
5. ↑ Editorial (2019-01-19). "Lista de alimentos con mucha sal o sodio". Botanical-online (in Spanish). Retrieved 2020-09-23.
6. ↑ "Síndrome nefrótico idiopático: diagnóstico histológico por biopsia renal percutanea". 2016-03-25. Archived from the original on 2016-03-25. Retrieved 2020-09-23.