Nephrotic syndrome is a condition characterized by swelling on hands, feet, abdomen, and face associated with increased levels of protein in the urine. It also leads to high levels of cholesterol and triglycerides in the blood. This condition arises when the kidneys do not function optimally and the protein from blood is leaked into the urine and excess water accumulates in the body. The filter system of the kidney is not able to selectively absorb the healthy products and remove toxins and waste products from the body. As a result, the body starts losing proteins from the body such as albumin and globulin that are responsible for optimal functioning of the immune system along with carrying lipids and enzymes in the body.(1)
What Leads To Nephrotic Syndrome?
Nephrotic syndrome is caused when the glomeruli of the kidney get damaged as a result of infections or other co-morbidities. The basement membrane of the renal glomerulus loses its permeability and as a result, the toxins and waste products are not fully filtered from the body. This results in the loss of healthy products from the body and accumulation of excess water that leads to edema in body tissues. The primary causes include membranous nephropathy, focal glomerulosclerosis, minimal change nephropathies and hereditary nephropathy that lead to inflammation of the kidney cells and their damage in the long run.(2)
Other causes that lead to damage of the kidneys are diabetes mellitus, lupus erythematosus, vasculitis, ANCA, Berger’s disease, glomerulonephritis, HIV infection, hepatitis B virus, cytomegalovirus, amyloidosis, and toxoplasmosis. Certain drugs like non-steroidal anti-inflammatory drugs and alloantibodies from enzyme replacement therapy also lead to kidney damage.(2)
The signs and symptoms of nephrotic syndrome include swelling in the feet, hands, and face. There is also the passage of frothy and bubbly urine which is indicative of advanced kidney disease and should be immediately consulted with a doctor. In some cases, the swelling can be more pronounced and affect multiple organs such as the lungs (pleural effusion) and abdomen (ascites). Complications might also arise as a result of infections such as pneumonia, peritonitis, renal vein thrombosis, and pulmonary embolism.(2)
Can Nephrotic Syndrome Be Cured?
The treatment of nephrotic syndrome is aimed at relieving the symptoms along with treating the underlying conditions aggravating kidney damage. Edema is treated by preventing sodium retention from taking place. Patients are mostly advised to limit their dietary intake of sodium and water. It is accompanied by the use of diuretics to remove excess water from the body. It is important to reverse edema slowly as any aggressive treatment might lead to electrolyte imbalance, thromboembolism, and acute renal failure. Frusemide is a loop diuretic that is mostly used to remove excess water from the body. When there is a poor response to loop diuretic then thiazide or potassium-sparing diuretics are used. In some cases, intravenous albumin is also given as it has shown to aid in diuresis.(3)
Proteinuria is also one of the major factors that need to be controlled in order to prevent Chronic Kidney Disease. ACE inhibitors are mostly used along with angiotensin receptor antagonists to control the increased release of protein in the urine. It is also mandatory to monitor the plasma electrolytes regularly as they take time to manifest the results. Dyslipidemia also resolves on its own once the proteinuria is brought under control.(3)
Lastly, it is necessary to improve the diet and maintain a healthy lifestyle to improve the kidneys function. To control proteinuria a low protein diet is not helpful as it can lead to a risk of negative nitrogen balance and malnutrition. It is important to take a diet low in sodium and water and fats to prevent the accumulation of water in the body. Any stress on the kidney should be avoided as it might further damage the kidneys and lead to chronic kidney disease and ultimately renal failure. With proper treatment and healthcare nephritic syndrome can be cured.
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