Nephritic syndrome is a condition where there is swelling present over the hands, feet, face, and abdomen. This is associated with the release of high amounts of protein in urine along with increased levels of cholesterol and triglycerides in the blood. It occurs as a result of damage to the glomeruli of the kidneys that filter the toxins and waste from the body. As a result, healthy proteins from the blood leak into urine and toxins are not fully filtered out from the body. It also leads to the retention of excess water taking place in the body tissues.(1)

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What Is The Best Treatment For Nephrotic Syndrome?

It can be diagnosed with urine tests where the proteinuria will be evident by 3+ to 4+ reading. A 3+ reading indicates a loss of 3 gram of protein daily in urine that is indicative of nephrotic syndrome. A urinalysis will show hyaline or granular casts and epithelial cells. Any amount of lipid in urine or tubular cells will be present as free globules in the casts. Blood tests will show serum albumin in the range of less than 2.5g/dl. Creatinine concentration is dependent on the degree of renal damage. Cholesterol and triglycerides levels are also markedly increased in the blood. The other causes can be ruled out by serological studies. Antinuclear antibodies, hepatitis B or C, rheumatoid factor, HIV antibody tests and tests for syphilis can help in testing for secondary causes of nephrotic syndrome. USG may be performed to look for glomerulosclerosis that is demonstrated by renal echogenicity. Lastly, a renal biopsy may be performed in children with congenital nephrotic syndrome.(1)

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Management of a patient with nephrotic syndrome is planned according to the degree of damage done to the kidneys. Steroid therapy is started in children mostly with low dose prednisone for a period of 4 weeks. In case of relapse levamisole, cyclophosphamide, cyclosporine, and mycophenolate mofetil can be given. Additionally, high blood pressure and proteinuria are treated accordingly by the use of ACE inhibitors and ARBs.

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When patients do not respond to medical treatment then dialysis may be required or in some cases, a kidney transplant may be the only choice. This is however needed in cases of chronic kidney disease or renal failure. It is therefore important the solve the underlying causes early and consult a doctor on time and start treatment immediately. A healthy diet should be taken along with restriction of intake of sodium and water. According to the age and weight of a person, the doctor will recommend the amount of water and sodium to be consumed in a day. For proper functioning of the kidneys, a high-fat diet should be avoided so that the load on kidneys is reduced and it can heal faster.(1)

Causes And Symptoms Of Nephrotic Syndrome

Kidney damage is the main cause of the nephrotic syndrome. There can be a temporary rise of proteins in urine or it could be persistently found in urine. Conditions such as dehydration, stress (emotional), extremely cold temperatures, fever, and strenuous activity or exercise can lead to a temporary rise in proteinuria. Other conditions that lead to a persistent rise in the level of protein in urine are kidney diseases such as amyloidosis, diabetes, lupus erythematosus, pyelonephritis, multiple myeloma, malaria, Berger's disease, Hodgkin's lymphoma, high blood pressure, heart failure, and glomerulonephritis. Other conditions include focal segmental glomerulosclerosis, pre-eclampsia, pregnancy, rheumatoid disease, sarcoidosis and sickle cell anemia.(2)

The symptoms to look out for kidney damage leading to the nephrotic syndrome are swelling in the face, hands, feet, and abdomen. These symptom scans become more pronounced if not treated on time. Certain complications like pneumonia, renal vein thrombosis, pulmonary embolism, and peritonitis are also likely to occur. The urine passed is frothy or bubbly in nature and could indicate the severe condition of the disease or kidney damage. If alarming symptoms appear then it should be consulted with a doctor immediately.(1)

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Sheetal DeCaria MD

Written, Edited or Reviewed By:

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Last Modified On: July 12, 2019

This article does not provide medical advice. See disclaimer

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