Nephrotic syndrome is a kidney ailment that causes your body to excrete an excessive amount of protein in your urine.
Damage to the clusters of tiny blood vessels in your kidneys that filter waste and excess water from your blood is frequently the cause of nephrotic syndrome. The disorder causes swelling, particularly in your feet and ankles, and raises your chance of developing other health issues.
Nephrotic syndrome treatment entails both treating the underlying illness and using drugs. Nephrotic syndrome increases your chances of getting infections and getting blood clots. To avoid issues, your doctor may advise you to take medicines or make dietary modifications.
WHAT ARE THE SYMPTOMS OF NEPHROTIC SYNDROME?
The following are signs and symptoms of nephrotic syndrome:
- Severe swelling (edema), notably around the eyes, ankles, and feet
- Foamy urine, which is caused by an overabundance of protein in your urine.
- Weight increase as a result of fluid retention
- Fatigue
- Appetite loss
WHAT ARE THE CAUSES OF NEPHROTIC SYNDROME?
Nephrotic syndrome is often caused by damage to your kidneys' clusters of small blood capillaries (glomeruli).
As your blood flows through your kidneys, the glomeruli filter it, separating what your body needs from what it doesn't. Healthy glomeruli prevent blood protein (mostly albumin) from leaking into your urine, which is required to maintain the proper quantity of fluid in your body. When glomeruli are destroyed, too much blood protein leaves the body, resulting in nephrotic syndrome.
Several potential causes
Nephrotic syndrome can result from a variety of illnesses and disorders, including:
- Diabetes-related kidney disease: Diabetes can cause kidney damage (diabetic nephropathy), affecting the glomeruli.
- minimal change illness: In children, this is the most prevalent cause of nephrotic syndrome. Minimal change illness causes impaired kidney function, although when inspected under a microscope, the kidney tissue appears normal or almost normal. Typically, the reason of the aberrant function cannot be discovered.
- Focal segmental glomerulosclerosis: This syndrome, characterized by scarring of portions of the glomeruli, can be caused by another disease, a genetic abnormality, or particular drugs, or it might arise for no known reason.
- Membranous nephropathy: This kidney condition is caused by thickening membranes within the glomeruli. The thickening is caused by immune system deposits. It can be caused by various medical illnesses such as lupus, hepatitis B, malaria, or cancer, or it might happen for no apparent reason.
- Systemic lupus erythematosus: This chronic inflammatory illness can cause significant kidney damage.
- Amyloidosis: This illness develops when amyloid proteins build up in your organs. Amyloid accumulation frequently wreaks havoc on the kidneys' filtration function.
WHAT ARE THE RISK FACTORS FOR NEPHROTIC SYNDROME?
The following factors can raise your risk of nephrotic syndrome:
- Medical diseases that might cause kidney injury: Diabetes, lupus, amyloidosis, reflux nephropathy, and other kidney illnesses all raise your chances of getting nephrotic syndrome.
- Some medicines: Nonsteroidal anti-inflammatory medicines and antibiotics are examples of medications that may cause nephrotic syndrome.
- Specific infections: HIV, hepatitis B, hepatitis C, and malaria are all infections that raise the risk of nephrotic syndrome.
WHAT ARE THE COMPLICATIONS OF NEPHROTIC SYNDROME?
The following are examples of nephrotic syndrome complications:
- Blood clots: The glomeruli's inability to filter blood effectively can result in the loss of blood proteins that assist avoid clotting. This raises your chances of getting a blood clot in your veins.
- High blood cholesterol and elevated blood triglycerides: When the protein albumin in your blood decreases, your liver produces more albumin. Simultaneously, your liver produces more cholesterol and triglycerides.
- Poor nutrition: Malnutrition can occur when too much blood protein is lost. This might result in weight loss that is obscured by edema. You may also have insufficient red blood cells (anemia), low blood protein levels, and low vitamin D levels.
- High blood pressure: Damage to your glomeruli and the accompanying buildup of extra fluid in your body might cause your blood pressure to rise.
- Acute kidney damage: Waste materials can quickly accumulate in your blood if your kidneys lose their capacity to filter blood owing to glomeruli injury. If this occurs, you may require emergency dialysis, which is an artificial method of eliminating excess fluids and waste from your blood, often using an artificial kidney machine (dialyzer).
- Chronic kidney disease: Nephrotic syndrome can cause kidney function to deteriorate over time. If your kidney function deteriorates sufficiently, you may require dialysis or a kidney transplant.
- Infections: Infections are more likely in people with nephrotic syndrome.
HOW IS NEPHROTIC SYNDROME DIAGNOSED?
The following tests and methods are used to diagnose nephrotic syndrome:
- Urine tests: A urinalysis can detect anomalies in your urine, such as high protein levels. You may be requested to collect urine samples over the course of 24 hours.
- Blood tests: A blood test can reveal low quantities of the protein albumin, as well as lower levels of blood protein overall. Albumin deficiency is frequently related with an increase in blood cholesterol and triglycerides. The amounts of creatinine and urea nitrogen in your blood may also be examined to determine your overall kidney function.
- Kidney biopsy: Your doctor may advise you to take a tiny sample of kidney tissue for testing. A needle is pushed through your skin and into your kidney during a kidney biopsy. Kidney tissue is taken and submitted to a laboratory for analysis.
WHAT ARE THE TREATMENTS FOR NEPHROTIC SYNDROME?
Nephrotic syndrome treatment include addressing any medical problem that may be causing your nephrotic syndrome. Your doctor may also offer drugs and dietary modifications to help control your symptoms or treat nephrotic syndrome consequences.
Medicines may include:
- Medication for high blood pressure: Angiotensin-converting enzyme (ACE) inhibitors lower blood pressure and the quantity of protein excreted in the urine. Lisinopril (Prinivil, Qbrelis, Zestril), benazepril (Lotensin), captopril, and enalapril are examples of medications in this group (Vasotec).
Angiotensin II receptor blockers (ARBs) are another class of medications that act similarly to losartan (Cozaar) and valsartan (Diovan). Other drugs, like as renin inhibitors, may be utilized as well, although ACE inhibitors and ARBs are usually taken initially.
- Water tablets (diuretics): These reduce edema by boosting the fluid production of your kidneys. Furosemide is a common component of diuretics (Lasix). Spironolactone (Aldactone, Carospir) and thiazides such as hydrochlorothiazide or metolazone are examples of others (Zaroxolyn).
- Medications to lower cholesterol: Statins can aid in the reduction of cholesterol levels. However, it is unclear if cholesterol-reducing drugs can improve outcomes for persons with nephrotic syndrome, such as preventing heart attacks or lowering the chance of mortality.
Atorvastatin (Lipitor), fluvastatin (Lescol XL), lovastatin (Altoprev), pravastatin (Pravachol), rosuvastatin (Crestor, Ezallor), and simvastatin are all statins (Zocor).
- Blood thinners (anticoagulants): These may be recommended to reduce the ability of your blood to clot, especially if you've had a blood clot. Heparin, warfarin (Coumadin, Jantoven), dabigatran (Pradaxa), apixaban (Eliquis), and rivaroxaban are examples of anticoagulants (Xarelto).
- Immune system-suppressing drugs: Immunosuppressive medications, such as corticosteroids, help reduce the inflammation associated with certain of the illnesses that might cause nephrotic syndrome. Rituximab (Rituxan), cyclosporine, and cyclophosphamide are among the medications used.