This is a kidney disorder characterized by a group of symptoms such as elevated level of protein in the urine (proteinuria), high level of fat and cholesterol in the blood (hyperlipidemia), swelling of various parts of the body (edema) and the low levels of albumin in the blood (hypoalbuminemia). Nephrotic syndrome is the result of damage to the kidneys filters called glomeruli which are tiny blood vessels responsible for the filtering of waste from the blood. After filtering out the waste products, the glomeruli filter allows the blood to retain the proteins required by the body. However, the proteins from the blood such as albumin can leak into the urine when the kidney filter becomes damaged. Among the affected individuals, the damaged glomeruli allow 3 grams or more of protein to leak into the urine over a 24 hour period. This syndrome can also increase the risk of infections and blood clots.
Causes
This condition develops as the result of damage to the kidneys which causes it to release the excess protein in the urine. The common cause of this among the children is the minimal change disease when the kidney function is abnormal even though the kidney tissue appears to be normal when examined under the microscope. Among the adults, the common cause appears to be the result of membranous glomerulonephritis when the deposits on the glomeruli can become harmful. It can also develop because of systematic disease that can affect several parts of the body such as diabetes or lupus. Some of the other conditions that cause the disorder include focal segmental glomerulosclerosis, amyloidosis, heart failure, the use of certain medications, genetic disorders and a blood clot in a kidney vein.
Symptoms
The swelling (edema) is one of the common symptom associated with this condition which can occur in the face and around the eyes, in the abdominal area, and in the arms and the legs particularly the feet and the ankles. Additional symptoms can include skin rash, poor appetite, weight gain from excess fluid retention, seizures and foamy urine.
Diagnosis
This condition can be suspected with the elevated amount of protein in the urine. The urine sample measures the level of albumin and creatinine which is the waste product from the muscle breakdown. When this condition is diagnosed, additional blood tests may be required to test for a systemic disease that can cause the disorder. In some cases, a kidney biopsy may be needed to determine the underlying cause of nephrotic syndrome.
Treatment
The treatment is based on the underlying cause and to reduce the symptoms evident such as the high blood pressure, high cholesterol and edema. This usually consists of medications and changes to the diet. The medications can include water pills (diuretics) to manage the swelling and blood thinners to reduce the ability of the body to develop blood clots.
References
http://www.mayoclinic.org/diseases-conditions/nephrotic-syndrome/basics/treatment/con-20033385
https://www.niddk.nih.gov/health-information/kidney-disease/nephrotic-syndrome-adults
https://medlineplus.gov/ency/article/000490.htm
