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What Causes Relapse In Nephrotic Syndrome?

Nephrotic syndrome is a condition characterized by leakage of large amounts of protein into the urine due to damage in the kidneys. It can occur at any age in any person. It is usually detected more in the children of age 2 to 5 years old. Its incidence is more common in males than in females. It is usually diagnosed in 1 in every 50,000 children. Its relapses are less common as they grow older. Its symptoms include swelling in the face and lower extremities. It can be treated with medicines and the patient may require strong medicines during relapses.

What Causes Relapse In Nephrotic Syndrome?

ephrotic syndrome can be treated with steroid medicine named prednisolone. With this medicine, the symptoms disappear in a few weeks. But it is observed in many children that the symptoms may return back and the patient requires steroid medicines again. In a few children, these relapses occur often. It is then called frequently relapsing nephrotic syndrome that requires stronger medication to get cured.(2)

Nephrotic syndrome is successfully treated with steroids but in certain cases, nephrotic syndrome is sensitive to steroids. It is called steroid-sensitive nephrotic syndrome (SSNS). It is noted that nearly half of children who have SSNs have relapses that come two to more times in six months or four or more times in one year. However, SSNS improves well with steroids, but it returns back in a short time. Some children may suffer from them throughout their life and as they grow into their teenage and adulthood, the relapses of nephrotic syndrome reduce and becomes less frequent.(2)

Some children develop steroid dependence. It means nephrotic syndrome relapse back within the two weeks after steroid therapy is withdrawn.(3) The cause of relapse of nephrotic syndrome is often linked with the weak immune system which cannot secure the body against infection and diseases.(1)

According to recent studies, frequent attacks of respiratory tract infections have triggered 67 % of cases of nephrotic syndrome. These infections happen in upper respiratory tract often caused by a virus. It can be managed with corticosteroids during its onset to avoid the relapse of the syndrome. Zinc supplementations often reduce the relapses in children with SSNS.(3)

Frequent episodes of urinary tract infections may also trigger the nephrotic syndrome. According to various studies, UTI is the main cause of relapse of nephrotic syndrome and it also delays the response of the kidneys towards steroid therapy. Diarrhea, peritonitis, and skin infections can also lead to their relapses.(3)

Nephrotic syndrome is a bunch of symptoms that signal towards the damage of the kidneys. It is not a disease but it develops due to damaged blood vessels in the kidneys that lead to faulty filtration (leakage) of protein. The damage in the kidneys is caused by different disorders. It can affect any person at any age.(1) It can affect children in the age between 2 to 6 years. It affects men more than women. Some children who are born with Nephrotic syndrome may require a kidney transplant to get rid of this syndrome forever.(1)

The main function of the kidney is to filter waste products from the blood. If any kidney conditions like membranous nephropathy, focal segmental glomerulosclerosis (a genetic defect), minimal change disease and renal vein thrombosis develop, then the kidneys get damaged and nephrotic syndrome may arise. The filtration process through the kidneys is disturbed and protein gets leaked through the kidney. It then leads to a reduction in the protein levels in the blood resulting in swelling in lower extremities and face.(2)


Nephrotic syndrome has good prognosis but its relapses are common in young children. It becomes infrequent when the child grows to an adolescent or adult.. upper respiratory tract infections, weak immune system, urinary tract infections, diarrhea, peritonitis, and skin infections may trigger the nephrotic syndrome.


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Sheetal DeCaria, M.D.
Sheetal DeCaria, M.D.
Written, Edited or Reviewed By: Sheetal DeCaria, M.D. This article does not provide medical advice. See disclaimer
Last Modified On:July 4, 2019

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