Alternate Names: Ellis type II; Nephrosis
Causes and Risks: Nephrotic syndrome is a group of signs and symptoms. It is caused by disorders that result in some type of damage to the kidney glomerulus, leading to abnormal excretion of protein in the urine.
This may occur as a result of infection, drug exposure, malignancy, hereditary disorders, or diseases that affect multiple body systems including diabetes mellitus (THE MOST COMMON CAUSE IN ADULTS), systemic lupus erythematosus, multiple myeloma, and amyloidosis.
It may also occur in disorders of the kidney, including glomerulonephritis, focal and segmental glomerulosclerosis, minimal change disease (THE MOST COMMON CAUSE IN CHILDREN), membranous glomerulonephritis, and mesangiocapillary glomerulonephritis.
Nephrotic syndrome occurs in about 2 out of 10,000 people. In children, the peak incidence of nephrotic syndrome is in the preschool years, usually when the child is 2 to 3 years old. There is a slight male predominance.
Prevention: Treatment of causative disorders may prevent development of nephrotic syndrome.
Symptoms:
Signs and Tests: A physical examination confirms the symptoms. Symptoms and signs of causative disorders may be present.
A urinalysis reveals large amounts of urine protein. Fats are often also present in the urine.
Tests to rule out causes may include:
This disease may also alter the results of the following tests:
Treatment: Treatment goals are to relieve symptoms, to prevent complications, and to retard progressive kidney damage. Treatment of the causative disorder is necessary to control nephrotic syndrome. Treatment may be chronic.
Corticosteroid, immunosuppressive, antihypertensive, and diuretic medications may help control symptoms. Antibiotics may be needed to control infections.
If hypertension is present it must be treated vigorously. Treatment of high blood cholesterol and triglyceride levels is recommended to reduce the development of atherosclerosis. Dietary limitation of cholesterol and saturated fats may be of little benefit, as the high levels seem to be the result of overproduction by the liver rather than excessive intake of fats. Medications to reduce cholesterol and triglycerides may be recommended.
High-protein diets are of debatable value. In many patients, reducing the amount of protein in diet produces decrease in urine protein. In most cases, a moderate-protein diet (1 gram of protein per kilogram of body weight per day) is usually recommended. Sodium (salt) may be restricted to help control edema. Vitamin D may need to be replaced if the nephrotic syndrome is chronic and unresponsive to therapy.
Prognosis: The outcome varies; the syndrome may be acute and short-term or chronic and unresponsive to therapy. The cause and development of complications also affects the outcome.
Complications:
Call your health care provider if symptoms indicate nephrotic syndrome may be present.
Call your health care provider if nephrotic syndrome persists or if new symptoms develop, including severe headache, fever, sores on the skin, cough, discomfort with urination, or decreased urine output.
Go to the emergency room or call the local emergency number (such as 911) if convulsions occur.
