What Causes Nephrosis & How is it Treated?

Nephrosis is a pathological condition of the kidneys which results in excretion of excessive protein from the urine. This condition usually is a cause of damage to small blood vessels in the kidneys whose function is filtration of waste material and excess water from the body.

Nephrosis results in development of edema especially in the feet and ankles and makes the individual prone to other potentially serious health issues. Nephrosis increases the risk of the individual to develop clots and frequent infections. Activity modifications and dietary changes are a must for prevention from complications of Nephrosis.

As stated, Nephrosis is caused by damage to tiny clusters of blood vessels in the kidneys. These blood vessels are known as glomeruli. The function of these blood vessels is to filter out waste products in the body and excess water if present. Under normal conditions, these blood vessels prevent the protein from seeping into the urine whereas in cases of Nephrosis protein seeps into the urine and goes out of the body resulting in protein deficiency. Now the question is what can damage these blood vessels or what is medically called as glomeruli. There are many disease conditions that can cause damage to the glomeruli. These conditions are:

Minimal Change Disease: This is by far the most common cause of nephrosis in children. This disease causes abnormal kidney function but when examined and the kidney tissue is analyzed it looks almost normal. Because of abnormal kidney function, this can damage the glomeruli and cause Nephrosis.

Focal Segmental Glomerulosclerosis: This is a condition in which there is scarring of the glomeruli. It may be caused due to some other medical condition or the cause can be idiopathic. This scarring of the glomeruli tends to cause Nephrosis.

Membranous Nephropathy: This is a renal disorder in which the membranes of the glomeruli get thick resulting in Nephrosis.

Diabetes: It is well known that diabetes can affect the renal function adversely and hence is a common cause for Nephrosis.

Systemic Lupus Erythematosus: This condition can also lead to severe kidney damage with resultant Nephrosis.

Renal Vein Thrombosis: This is a condition in which there is blockage of a vein that is connected to the kidneys because of a clot. This may result in damage to normal blood flow to the kidney with resultant damage to the glomeruli and hence causing Nephrosis.

Some of the risk factors for Nephrosis are:

• People with medical conditions like diabetes or SLE are prone to develop Nephrosis.
• Medications. There are also certain medications which can affect the kidney function and damage the glomeruli. These medications are prolonged use of NSAIDs and the like:
• Infections. Certain infections that may put an individual at risk for Nephrosis are HIV, hepatitis B, hepatitis C, and malaria.

Some of the symptoms of Nephrosis are:

• Severe edema especially in the feet, ankles, and around the eye region
• Foamy urine as a result of excess protein in the urine can be a symptom of nephrosis.
• Excess weight gain due to fluid retention.

Some of the tests done to diagnose Nephrosis are:

Urinalysis: This can clearly show the presence of excess proteins in the urine thus pointing clearly to Nephrosis.

CBC: This test will clearly show that there is a decrease in the count of proteins in the blood, a condition called as hypoalbuminemia.

Kidney Biopsy: In case if Nephrosis is suspected, the physician make take a sample of the kidney tissue and send it for analysis to look for any abnormalities.

All the above tests will confirmatively diagnose Nephrosis.

The treatment for Nephrosis is aimed at controlling symptoms and treating the underlying cause of the condition. Once an underlying cause for Nephrosis is identified then the physician may recommend medications to treat the condition. Some medications that are given for treatment for Nephrosis are:

Antihypertensives Medications to Treat Nephrosis: ACE inhibitors are the frontline medication given for blood pressure control. It also reduces the amount of protein released in the urine. Examples of this class of medications are: Lotensin, Capoten, and Vasotec. Another class of medications known as angiotensin II receptor blockers also work the same way as the ACE inhibitors and may also be recommended. Medications that come under this category are losartan and valsartan.

Diuretic to Treat the Symptoms of Nephrosis: These medications are given solely for water retention and help with the edema in the feet, ankles, and around the eyes. These medications work by increasing the urine output. Medications that come under this category are Lasix and Aldactone

Anti-cholesterol Agents: Cholesterol levels can be managed by drugs called as statins, although it is still not confirmed that such medications are helpful in treating Nephrosis.

Anticoagulant: Also known as blood thinners reduce the risk of the body developing blood clots and hence the chances of developing a blood clot in the vein of the kidneys becomes very less. Medications that come under this category are heparin and warfarin.

The overall prognosis of Nephrosis is quite variable in that some people recover completely with little to no intervention and some people despite aggressive interventions still worsen and continue to have symptoms. Some of the complications that can arise with treatment for Nephrosis are conditions like atherosclerosis and adverse reaction to medications. People also tend to have side effects to medications given to them for treatment of Nephrosis.

A balanced and good diet is quite helpful for patients with Nephrosis and goes a long way in helping their symptoms. The patient needs to consult with a dietician who will give a detailed chart as to what and what not to eat to control the symptoms of Nephrosis. Some of the diet tips for people with Nephrosis are:

• Avoid eating foods high in protein as it may lead to further kidney damage.
• Restrict salt intake so that there is less water retention and edema is controlled and it also keeps the blood pressure in check
• A low cholesterol diet is also quite helpful in controlling symptoms of Nephrosis.

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