Key Facts You Need to Know About Nephrotic Syndrome

Nephrotic syndrome refers to a condition where an excessive amount of protein leaks into the urine, leading to facial swelling and fatigue. This typically arises from harm to the tiny blood vessels within the kidneys. The symptoms include significant swelling around the face and ankles, as well as heightened susceptibility to various health issues. Nephrotic syndrome affects individuals across all ages and both sexes; however, young boys between two and five years old have a higher likelihood of developing this ailment compared to older groups. In adults, it may occur at any point in life irrespective of gender.

Nephrotic syndrome typically arises due to harm inflicted upon the glomeruli (clusters of tiny blood vessels within the kidneys). The role of these structures is to sift through the blood, distinguishing between necessary components and those deemed unnecessary. Intact glomeruli ensure an appropriate balance of fluids and vital proteins remains in circulation throughout the body. However, when they become impaired, their ability to perform this task correctly becomes disrupted.

A number of illnesses can impair the glomeruli, leading to nephrotic syndrome. Both unregulated and prolonged diabetes have been recognized as harmful factors for kidney health, particularly affecting these tiny blood vessels and causing nephrotic syndrome. Among pediatric cases, minimal change disease stands out as the predominant factor behind nephrotic syndrome. Additionally, localized scarring within certain glomeruli—often triggered by various conditions or medications such as specific analgesics, diuretics, anabolic steroids, and drugs like bisphosphonates prescribed for osteoporosis—can inflict targeted injury upon the glomeruli, thereby contributing to nephrotic syndrome.

Responses differ from person to person. The thickening of the glomerular membrane is likewise associated with triggering nephrotic syndrome. This condition may result from illnesses such as amyloidosis and systemic lupus erythematosus, which lead to kidney harm and subsequently trigger nephrotic syndrome. Various infections including hepatitis B, C, HIV, and malaria, also elevate the likelihood of developing nephrotic syndrome.

Because of the lost proteins in the urine, the body’s capacity to stop clots from forming decreases, leading to a higher chance of blood clots developing within the veins. As the level of blood albumin drops, the liver needs to produce additional albumin. At the same time, this process causes the liver to release extra cholesterol and triglycerides into the bloodstream, which increases their concentrations.

It raises the chances of developing heart disease and suffering from strokes. Elevated blood pressure stems from an abundance of fluids within the body. The loss of protein diminishes immune function, thereby boosting susceptibility to infections. Additionally, this condition often brings about deficiencies in iron and Vitamin D. These nutritional shortcomings are concealed by the edema present in patients with nephrotic syndrome. Renal functionality becomes impaired because of the harm inflicted, potentially leading to renal failure, which may require dialysis treatment or even a kidney transplant.

The diagnosis of nephrotic syndrome relies on a physical exam, analysis of urine showing the presence of albumin, and blood tests indicating elevated levels of cholesterol and triglycerides. If performed, a kidney biopsy may help identify the root cause.

The treatment involves limiting salt and fat intake in the diet. Consuming plant-based proteins is beneficial. Iron and vitamin D supplements can address deficiencies in these nutrients. Incorporating green vegetables and fresh fruits into your meals is also helpful. Diuretics, which aid in eliminating excess fluids and salts from the body, are administered routinely. To manage hypertension, medications belonging to either the class of ACE inhibitors or ARBs are prescribed.

High levels of cholesterol can be lowered with medications such as statins which are designed to reduce cholesterol. In cases where there’s a potential for blood clots to develop, doctors may prescribe anticoagulant drugs. To alleviate persistent inflammation often associated with various disorders leading to nephrotic syndrome, corticosteroids might be administered.

It’s impossible to prevent every cause of nephrotic syndrome, but some known risk factors can indeed be mitigated. If hypertension or diabetes are issues, they should be managed through dietary changes, consistent physical activity, and medication as needed. Getting vaccinations for prevalent infections and completing antibiotic treatments when infected with anything else is crucial. Staying at a healthy weight, eating a nutritious diet, exercising regularly, and abstaining from tobacco and alcohol consumption can help maintain overall health and reduce susceptibility to infections that might trigger nephrotic syndrome.

Dr Rachna Pande specializes in internal medicine.

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