Nephrotic Syndrome

Nephrotic syndrome happens when you have a disease that damages the filters in your kidneys and causes them to not work as they should. There are primary and secondary causes of nephrotic syndrome.

Primary causes of nephrotic syndrome are diseases that affect only the kidneys.

The most common primary cause of nephrotic syndrome in adults is a disease called focal segmental glomerulosclerosis (FSGS). The only way to know for sure whether you have FSGS is to get a kidney biopsy. Even when treated, most people with FSGS will eventually develop kidney failure and will need to start dialysis or have a kidney transplant to live. After transplant, there is still a chance that FSGS will return and you may lose your new kidney.

In children, the most common primary cause of nephrotic syndrome is minimal change disease.

Secondary causes of nephrotic syndrome are diseases that affect the whole body, including the kidneys.

Most of the time, nephrotic syndrome happens because of secondary causes. The most common secondary cause of nephrotic syndrome in adults is diabetes.

The most common secondary cause of nephrotic syndrome in children is diabetes.

When you have nephrotic syndrome, an important protein called albumin leaks into your urine instead of getting filtered by the kidneys as it should. Albumin helps your body get rid of extra fluid. When you do not have enough albumin in your blood, fluid can build up in your body, causing swelling in your legs, feet and ankles. You can also have other problems such as blood clots and infections.

With nephrotic syndrome, cholesterol also builds up in your blood. When you have too much cholesterol in your blood, clumps form inside your veins and arteries, which can cause a heart attack or a stroke.

Nephrotic syndrome can also cause other serious health problems such as:

• Anemia
• Heart Disease
• High Blood Pressure
• Fluid Buildup
• Acute Kidney Injury
• End-Stage Renal Disease (ESRD) or Kidney Failure

Healthy kidneys remove extra fluid and waste from your blood but let proteins and other important nutrients pass through and return to your bloodstream. The only way to know how well your kidneys are working is to get tested. Tests doctors use for kidneys are:

• Urine tests – Your urine test results can tell your doctor if there is protein in your urine. If so, you may have nephrotic syndrome. Protein in the urine is one of the earliest signs of kidney disease.
• Blood tests – Your blood test results can tell your doctor if your kidneys are filtering waste like they should. If not, it could be a sign of nephrotic syndrome.
• Kidney biopsy – In a kidney biopsy, your doctor will look at a small piece of your kidneys under a microscope for signs of damage and disease.

To be sure you do not have a problem with your kidneys, you should have both a urine and a blood test. Having a urine and a blood test is important because you could have normal blood test results, but you could still have too much protein in your urine.

Protein in your urine could mean you have kidney disease.

There is no cure for nephrotic syndrome, but your doctor might tell you to take certain medicines to treat the symptoms. and to keep the damage to your kidneys from getting worse.

• Medicine to control blood pressure and cholesterol can help prevent you from having a heart attack or a stroke.
• Medicine to help your body get rid of extra water can help control your blood pressure and can reduce swelling.

Changing how you eat may also help you manage your symptoms. When you have nephrotic syndrome, a dietitian may recommend you make changes to the amount of protein, salt, and fat that you eat. Check out Kidney Kitchen to learn more about how these nutrients can affect your kidneys.

Protein

The amount of protein you should eat depends on how healthy your kidneys are. For some people with nephrotic syndrome, eating less protein is best. Talk to a dietitian about how much protein you should eat.