Nephrotic Syndrome

Nephrotic syndrome is a lesion in the kidney that causes an increase in protein levels in the urine. High protein levels are caused by leakage in the kidney that filters the blood (glomerulus).

Nephrotic syndrome can occur in children and adults. This condition can be treated by taking medication given by a doctor. If the nephrotic syndrome is caused by another disease, such as diabetes or lupus, the doctor will also treat conditions that cause nephrotic syndrome.

Nephrotic Syndrome
Symptoms of Nephrotic Syndrome

The main symptom of Nephrotic Syndrome is fluid accumulation in the body or edema. Edema is caused by a low protein content in the blood, which causes fluid leakage into blood vessels and accumulation in body tissues.

In children, edema caused by nephrotic syndrome can be observed after facial swelling. In adults, edema due to heel swelling can be observed, followed by swelling of the calf and thigh.

Other symptoms of nephrotic syndrome that may appear are:

  • Urine is foaming because of protein in the urine.
  • Diarrhea
  • nausea
  • Tired, lethargic and loss of appetite.
  • Weight gain due to accumulation of body fluids.

Nephrotic syndrome caused by other diseases will also cause symptoms of the disease. For example, nephrotic syndrome caused by rheumatoid arthritis can cause symptoms of joint pain.
When to see a doctor

If you have lupus or diabetes, follow your doctor's recommendations and maintain control regularly, even if it doesn't cause symptoms. Both of these diseases require long-term treatment.

Seek immediate medical attention if symptoms of Nephrotic Syndrome appear, such as edema followed by foamy urine, for immediate doctor's help. This must be done because untreated nephrotic syndrome can cause chronic and permanent kidney failure.
Causes of Nephrotic Syndrome

Nephrotic syndrome results from glomerular lesions, the part of the kidney that filters blood and forms urine. As a result, proteins that must remain in the blood infiltrate the urine. Under normal conditions, urine must not contain protein.

Damage to the kidneys can be caused by kidney cells that thicken or form scar tissue. Until now, the cause of the thickening or formation of glomerular scar tissue is unknown. Nephrotic syndrome caused by glomerular thickening or scar tissue formation is also called primary nephrotic syndrome.

In addition to thickening and formation of scar tissue in the kidney, nephrotic syndrome can be caused by other diseases that damage the kidneys. This condition is called secondary nephrotic syndrome. Some diseases can cause secondary nephrotic syndrome, including:

  • Diabetes
  • lupus
  • Infectious diseases, such as leprosy, syphilis, HIV, malaria or hepatitis B and hepatitis C.
  • Rheumatoid arthritis.
  • Henoch-Schönlein Purpura.
  • amyloidosis
  • Cancer, such as leukemia or lymphoma.
  • Sjogren's Syndrome.
  • Erythema multiforme

In addition to the diseases mentioned above, taking drugs that affect the work of the kidneys, such as nonsteroidal anti-inflammatory drugs or alpha interferon, can also increase the risk of developing nephrotic syndrome. Misuse of heroin also carries the risk of causing nephrotic syndrome.

Diagnosis of nephrotic syndrome
During the initial examination, the doctor will ask about the symptoms experienced and will check the physical condition of the patient. In addition, the doctor will also ask questions about the patient's medical history, especially the illness he has suffered.

If the patient is a child, the doctor will also ask the family if a family member has ever suffered from the disease.

If the doctor suspects a person with nephrotic syndrome, he will carry out other tests, including:
Urine test

The urine sample will be examined in a laboratory to see if there is a protein leak. The doctor can ask the patient to take 24 urine samples.
Blood test
Blood tests are done by taking a patient's blood sample to check the level of protein in the blood (albumin), accompanied by a kidney function test. Blood tests can also be done to determine the cause of nephrotic syndrome, for example to check blood sugar levels of diabetics.
Kidney biopsy

This procedure is used to take tissue samples from the kidney. Kidney biopsy is performed to examine kidney tissue under a microscope.
Treatment of nephrotic syndrome

Treatment of nephrotic syndrome by a kidney doctor will be different for each patient, depending on the cause. Some drugs can be given to people with Nephrotic Syndrome, including:

  • Corticosteroid medicine
  • These drugs work against kidney inflammation or against inflammatory diseases that cause nephrotic syndrome, such as lupus or amioloidosis. An example of this drug is methylprednisolone.
  • Antihypertensive drugs
  • This medicine is used to reduce high blood pressure, which can increase if you have kidney damage. In addition, hypotension drugs can reduce the amount of protein wasted in the urine. Examples of these drugs are ACE inhibitors, such as enalapril or catropril.
  • Diuretic medicine
  • The goal of diuretic treatment is to remove excess fluid from the body to reduce the symptoms of edema. Furosemide is an example of this drug.
  • Anticoagulant drugs
  • The function of this drug is to reduce the risk of blood clots, a complication of nephrotic syndrome. Heparin is an example of this drug.
  • Penicillin drug
  • Penicillin is an antibiotic used to prevent infections that complicate nephrotic syndrome.

If the protein level in the blood is too low, the doctor can give intravenous albumin. The doctor will also advise dialysis or kidney transplant patients if they have experienced chronic kidney failure.

In addition to medication, the diet of patients with nephrotic syndrome must be regulated. Patients must consume enough protein, not too much or less. In addition, people with Nephrotic Syndrome need to reduce their intake of salt, fat, and cholesterol to prevent complications and reduce edema. Consult a nutritionist about the diet of people with Nephrotic Syndrome.

The cure rate of this condition depends very much on the cause, severity and body response to treatment. As a rule, children with age can recover, although around 70% of them return to experience it later.

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