Nephrotic syndrome is characterized by swelling over the hands, feet, face, and abdomen. There is also marked proteinuria or large amounts of protein released in urine due to non-functioning of the kidneys. The other associated factors are increased levels of cholesterol and triglycerides in the blood. Since kidneys are the filter system of the body they retain water and healthy products in the body while flushing out toxins and waste products in urine. When the glomerulus of the kidneys are damaged they lose their permeability and as a result, the proteins leak into the urine and water is excessively absorbed and retained in the body leading to edema and further damage to the kidneys take place.(1)
What Are The First Symptoms Of Nephrotic Syndrome?
It is important to assess the patient’s current clinical state and to rule out any complications that might be present. It is also necessary to formulate whether the nephrotic syndrome is due to a primary cause or due to any underlying kidney disease. The first sign to appear is the periorbital edema followed by edema of the legs and feet and hands. It could also lead to complications such as pleural effusion, ascites and pericardial effusions. In some cases, genital edema may also be seen. Due to low albumin in the blood, a person will feel tired most of the time and breathlessness may be seen due to pleural effusion and overload of fluid along with acute renal failure. Chest pain might be present when there is the presence of a thrombus. Frothy urine could also be a sign of Chronic Kidney Disease.(1)
All the symptoms should be carefully addressed and the patient should be referred to a nephrologist for further management. The complications of nephrotic syndrome include breathing difficulties, peritonitis, sepsis, edema all over the body and formation of a blood clot. The early symptoms can usually be treated successfully with steroid therapy without the person going into relapse. It is only when the disease has advanced with complications that dialysis and renal transplant is required.(2)
How Do You Test For Nephrotic Syndrome?
A diagnosis is made on the basis of a thorough history of the patient suggestive of nephritic syndrome followed by a series of tests to confirm the diagnosis. A patient’s renal function should be measured by the assessment of serum urea and creatinine. A dipstick test is done for excess passage of protein in urine and a range of 3+ to 4+ indicates loss of protein in the nephrotic range. An early morning sample is mostly preferred as they give quicker more accurate results. Albumin to creatinine ratio can also measure proteinuria. Ultrasonography is also performed in some cases to assess the size and morphology of the renal cells. When signs of thrombosis are present then Doppler examination can also be done. Other tests can also be done to rule out other urine infections and underlying pathologies. A blood test will give a full blood count and a coagulation profile. Liver function tests may be needed to be performed to rule out any liver disease. Plasma calcium and glomerular filtration rate should also be tested. Other tests include serum analysis to look for any systemic diseases. They include immunoglobulins testing, urine electrophoresis, antinuclear antibody tests, hepatitis B and C and HIV testing should also be done. Chest X-ray along with renal ultrasound scan should be performed to rule out any complications. A biopsy may be required in rare cases where there are renal complications present along with hematuria.(2)
Lastly, management is done according to the underlying pathology and severity of the kidney damage. Protein loss should be controlled along with high blood pressure and cholesterol in the blood. A healthy diet and lifestyle will decrease toxin load on the kidneys and they will heal faster. Treatment should be taken as advised by the doctor for faster recovery.(1)
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