Nephrotic Syndrome: Causes, Symptoms & Treatment

Nephrotic syndrome refers to a kidney disorder that causes the body to excrete too much protein in the urine. This leads to dangerously low levels of blood proteins that are important for health, like albumin and globulin.

When the kidneys are damaged or diseased, they are unable to effectively filter wastes while holding on to vital protein molecules. This impaired filtration results in the spillover of protein from the blood into the urine, known as proteinuria or albuminuria.

People with nephrotic syndrome typically exhibit symptoms like abnormal swelling (oedema), foamy or frothy urine, fatigue, weight fluctuations, high cholesterol and an increased risk of infections and blood clots. Without treatment, nephrotic syndrome can cause severe complications. That’s why timely diagnosis and management is crucial.

What are the Main Causes of Nephrotic Syndrome?

Nephrotic syndrome is typically caused by damage or disease affecting the clusters of tiny blood vessels in your kidneys that filter waste and excess water from your blood. When these delicate blood vessels in the kidneys are damaged, excess protein can leak through. There are a few known  nephrotic syndrome causes and risk factors which are, divided into two categories:

Primary Causes

These refer to diseases or conditions that directly damage the glomeruli, which are tiny blood-filtering units inside the kidneys:

• Minimal Change Disease – This is the most common cause of nephrotic syndrome in children. As the name suggests, minimal changes are seen in the glomeruli, but leakage still occurs.
• Focal Segmental Glomerulosclerosis (FSGS) – Here, scarring and inflammation develop in parts of the glomeruli, leading to impaired filtration.
• Membranous Nephropathy – Antibodies build up in the glomeruli area, forming deposits that alter the kidney filtration membrane.

Secondary Causes

In secondary causes, the kidneys get damaged indirectly due to another health condition:

• Diabetes – Unchecked blood sugar levels can injure the blood vessels supplying the kidneys.
• Systemic Lupus Erythematosus – The autoimmune disease Lupus causes inflammation in the kidneys.
• Infections – Certain bacterial, viral and parasitic infections affect kidney function and health.
• Cancers – Types like lymphoma, leukaemia and multiple myeloma increase the risk of nephrotic syndrome.
• Medication Side Effects – Drugs like NSAIDs, antibiotics, and chemotherapeutics can sometimes harm the kidneys.
• Genetic Factors – Mutations in genes involved in kidney health may play a role.

Symptoms to Recognize Nephrotic Syndrome

Catching the common signs of nephrotic syndrome early and determining which underlying insult is driving protein leakage will enable the best treatment results. While nephrotic syndrome cannot always be cured outright, its progression can be slowed significantly when caught early. Familiarising oneself with its typical manifestations facilitates prompt detection and management. People with nephrotic syndrome often showcase the following signs and symptoms:

• Edema – Abnormal swelling in parts of the body, often more pronounced in the legs, ankles, feet, arms and face.
• Foamy or Frothy Urine – Due to high amounts of protein spilling into the urine, it may appear foamy.
• Fatigue and Weakness – Low protein absorption can cause tiredness, weakness and anaemia.
• Weight Fluctuations – Fluid retention leads to weight gain despite poor appetite and nutrition.
• High Cholesterol – With lower protein levels, more cholesterol circulates unchecked.
• Increased Susceptibility to Infections – Loss of crucial immune proteins impacts the body’s ability to fight infections.
• Blood Clots – Low albumin and protein C/S levels increase clotting risk.

Diagnosing Nephrotic Syndrome

To diagnose nephrotic syndrome, medical experts will:

• Evaluate Symptoms – Doctors will ask about symptoms like oedema, urine changes, fatigue, weight gain etc.
• Conduct Urine Test – The presence of high protein in urine indicates impaired kidney filtration.
• Order Blood Tests – Low albumin, protein, and globulin confirm proteinuria. Cholesterol levels are also assessed.
• Do a Kidney Biopsy – Examining kidney tissue under the microscope reveals patterns of damage that identify the cause.

Treatment Plan for Nephrotic Syndrome

Once the cause is determined, treatment aims to address the underlying disease, relieve symptoms, reduce protein loss, and prevent complications like infections, blood clots and kidney failure.

The ongoing management of nephrotic syndrome requires close collaboration between patients, primary care doctors, and nephrologists to monitor progression, watch for complications, and prevent permanent kidney damage through modern therapies. New treatments on the horizon aim to better target the underlying pathways causing protein leakage.

While nephrotic syndrome cannot always be cured, the wide range of treatments now emerging allow this complex condition to be better controlled. Catching it early and having excellent supportive care gives patients the best outcomes. By learning the various causes, telltale symptoms, diagnostic process and therapy options for managing nephrotic syndrome, patients can equip themselves to handle this condition.

 The treatment plan focuses on managing symptoms, reducing protein loss, and preventing complications by:

• Prescribing Medications – Corticosteroids, immunosuppressants, ACE inhibitors and diuretics help reduce protein leakage.
• Recommending Dietary Changes – Doctors may suggest a low-salt, low-fat, and high-protein diet.
• Treating Underlying Conditions – Tightly controlling diabetes, infections, autoimmune disorders, cancers etc. is key.
• Trying Plasmapheresis – This procedure filters excess antibodies and protein from the blood.
• Considering Dialysis – If kidneys are failing, dialysis artificially filters wastes and fluids.
• Discussing Transplant Options – A kidney transplant may be required in advanced cases of kidney failure.

With early intervention and careful adherence to treatment, most patients with nephrotic syndrome can manage it effectively. Regular follow-ups with a nephrologist are imperative.

Key Takeaways on Nephrotic Syndrome

• Nephrotic syndrome is a kidney disorder causing dangerously high protein excretion through urine.
• Various primary and secondary diseases can damage the kidneys’ filtration system.
• Symptoms like oedema, foamy urine, fatigue, weight gain, and high cholesterol are typical.
• Diagnosing the specific cause through urine, blood and kidney tests is vital.
• With timely treatment of symptoms and underlying conditions, prognosis can be good.

Dispur Polyclinic and Hospital stands as a beacon of excellence in healthcare, specialising in the comprehensive treatment of Nephrotic Syndrome. Our dedicated team of skilled healthcare professionals is committed to providing compassionate and personalised care to patients grappling with this renal condition. With state-of-the-art facilities and cutting-edge medical technologies, we offer a holistic approach to managing and curing Nephrotic Syndrome. 

If you or a loved one is seeking expert care and effective solutions for Nephrotic Syndrome, trust Dispur Polyclinic and Hospital to be your partner in health. Schedule a consultation today and take the first step towards a healthier tomorrow. Call +91 7670007615 or book an appointment online today.