Nephrotic Syndrome in Adults
En Español (Spanish Version)

Definition
Nephrotic syndrome happens when the kidneys let protein leak into the urine. When this happens, there is not enough protein in the blood. Low protein in the blood allows fluid to leak out of the blood stream and into body tissues.

Nephrotic syndrome is a collection of the following signs:

  • High protein in the urine
  • Low protein in the blood
  • Swelling of body tissues
  • High cholesterol in the blood
Nephrotic syndrome is not a disease itself. It is a set of signs and symptoms that indicate that another disease has damaged the kidneys, and that they are no longer working properly.

Causes
Nephrotic syndrome is caused by damage to tiny filters in the kidneys, called glomeruli. The glomeruli filter waste and excess water from the blood. This forms urine, which reaches the bladder via the ureters. Diseases that damage the glomeruli cause nephrotic syndrome.

Anatomy of the Kidney

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Diseases that may lead to nephrotic syndrome include:

  • Glomerulonephritis—inflammation of the glomeruli from infection or other causes
  • Diabetic nephropathy—kidney complications from diabetes
  • Membranous nephropathy
  • IgA nephropathy
  • Membranoproliferative glomerulonephritis
  • Renal amyloidosis—abnormal protein deposits in the kidneys
  • Minimal change disease
  • Other diseases, including systemic lupus erythematosus, certain infections, toxins, drugs, allergic reactions, sickle cell disease, renal vein thrombosis, and some types of cancer
Risk Factors
Tell your doctor if you have any of the following factors that increase your risk of nephrotic syndrome:

  • Diabetes
  • Lupus
  • Exposure to drugs or toxins
  • Certain infections
Symptoms
Symptoms may include:

  • Swelling around the following body parts:
    • Feet
    • Ankles
    • Abdomen
    • Hands
    • Face
    • Eyes
  • Weight gain from excess fluids
  • Shortness of breath
  • Poor appetite
  • Foamy urine
  • Fatigue
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done. High blood pressure may indicate kidney damage. A urine test will show if you have too much protein or any blood in your urine. A blood test will show if your blood contains too much cholesterol and not enough protein.

Your bodily fluids and tissues may be tested. This can be done with:

Images may need to be taken of your bodily structures. This can be done with:

If your doctor suspects nephrotic syndrome, you may be referred to a kidney specialist.

Treatment
Treatment depends on what is causing the nephrotic syndrome. Some cases are treatable with medicine, while others lead to kidney failure despite treatment. The underlying cause will be treated, if possible. Steps will be taken to:

  • Adjust your diet to replace protein lost in the urine
  • Use ACE inhibitors to reduce protein loss in some cases
  • Treat edema by restricting salt intake and taking diuretics, also known as water pills
  • Lower cholesterol and blood pressure with diet, exercise, and medicines
Prevention
Most conditions that lead to nephrotic syndrome cannot be prevented. However, the risk of type 2 diabetes may be reduced through exercise and weight control.




RESOURCES:
American Kidney Fund

National Kidney Foundation

CANADIAN RESOURCES:

The Kidney Foundation of Canada

References:
Nephrotic syndrome. National Kidney Foundation website. Available at: http://www.kidney.org/atoz/content/nephrotic.cfm. Accessed July 12, 2013.

Nephrotic syndrome in adults. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated November 28, 2012. Accessed July 12, 2013.

Nephrotic syndrome in adults. National Kidney and Urologic Disease Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/nephrotic/index.htm. Updated April 19, 2012. Accessed July 12, 2013.

Last Reviewed July 2013



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