Nephrotic Syndrome

Nephrotic syndrome (neff-rot-ick) is a condition in which your kidneys produce an excessive amount of protein in your urine (pee). Nephrotic syndrome is mainly caused by a problem with the kidney's filters (glomeruli). Glomeruli (glo-mare-yoo-lye) are small blood veins in the kidneys. They eliminate waste and surplus fluids from your blood and excrete them in your bladder as pee. Common waste products include urea, creatinine, and acids. In healthy kidneys, the glomeruli remove waste materials. They allow your blood to maintain the cells and proteins that your body requires to function normally.

Symptoms

Some common nephrotic syndrome symptoms include:

• Large amounts (greater than 3.5 grams) of the protein albumin in your urine (albuminuria).
• Hyperlipidemia refers to elevated levels of fat and cholesterol in the blood.
• Swelling (edema) commonly occurs in the legs, foot, or ankles. Swelling might also occur in your hands or face.
• Low levels of albumin in the blood (hypoalbuminemia).
• Appetite loss.
• Feeling ill or sick.
• Abdominal pain (pain ranging from the ribs to the pelvis).
• Foamy pee.

Another symptom of nephrotic syndrome is a loss of minerals and vitamins that are necessary for your health and growth, such as calcium and vitamin D. This could have an impact on the growth of children suffering from nephrotic syndrome. You could develop osteoporosis, which weakens your hair and nails.

Causes

Kidney illnesses frequently destroy the glomeruli. The diseases target your glomeruli, but healthcare practitioners and medical experts don't understand why. Nephrotic syndrome is mostly caused by damaged glomeruli. These diseases include:

• Amyloidosis. This is a disorder where amyloid proteins accumulate in your key organs. Amyloidosis is most typically found in the kidneys, impairing their ability to filter.
• Diabetes-related nephropathy. "Nephropathy" indicates that your kidney is not functioning properly. Diabetes-related nephropathy occurs when diabetes causes damage or dysfunction to one or more of your kidney's nerves. It often results in numbness, tingling, muscle weakness, and discomfort in the affected area.
• Focal segmental glomerulosclerosis (FSGS). Scarring in FSGS affects small sections (segments) of your glomeruli. It may cause edema, renal failure, and protein loss in your urine.
• Lupus. Lupus is an autoimmune illness that causes inflammation, swelling, and pain in your entire body, including your kidneys.
• Membranous nephropathy. Membranous nephropathy occurs when your immune system attacks the kidney's filtration membranes.
• Minimal change disease (MCD). This is a kind of nephropathy in which the kidneys do not function normally. However, a kidney biopsy reveals little to no damage to your glomeruli or renal tissue. MCD can develop at any age, but it is more prevalent in children.

Diagnosis

The following tests and procedures are used to diagnose nephrotic syndrome:

• Urine tests. A urinalysis can detect abnormalities in your urine, such as excess protein. You may be needed to collect urine samples during a 24-hour period.
• Blood tests. A blood test can reveal lower levels of albumin and blood protein in general. Loss of albumin is commonly linked to an increase in blood cholesterol and triglycerides. Creatinine and urea nitrogen levels in your blood may also be measured to assess overall kidney function.
• Kidney biopsy. Your doctor may consider removing a tiny sample of kidney tissue for testing. During a kidney biopsy, a needle is injected through your skin into your kidney. Kidney tissue is taken and sent to a laboratory for analysis.

Treatment

Treatment for nephrotic syndrome includes addressing any underlying medical conditions. Your doctor may also offer drugs and dietary modifications to help control your symptoms or treat the consequences of nephrotic syndrome. Medications may include:

• Blood pressure medicine. Angiotensin-converting enzyme (ACE) inhibitors lower blood pressure and urine protein levels. This category includes medications including lisinopril (Prinivil, Qbrelis, and Zestril), benazepril (Lotensin), captopril, and enalapril (Vasotec).
• Another class of medications that function similarly is known as angiotensin II receptor blockers (ARBs), which include losartan (Cozaar) and valsartan (Diovan). Other drugs, including renin inhibitors, may be used; however, angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are typically used initially.
• Water pills, sometimes known as diuretics. These aid in reducing edema by increasing your kidneys' fluid output. Furosemide (Lasix) is commonly used as a diuretic. Other medications include spironolactone (Aldactone, Carospir) and thiazides, such as hydrochlorothiazide or metolazone (Zaroxolyn).
• Cholesterol-lowering medicines. Statins can help reduce cholesterol levels. However, it is unclear if cholesterol-reducing drugs can improve outcomes for persons with nephrotic syndrome, such as preventing heart attacks or lowering the risk of premature mortality.
• Statins are atorvastatin (Lipitor), fluvastatin (Lescol XL), lovastatin (Altoprev), pravastatin (Pravachol), rosuvastatin (Crestor, Ezallor), and simvastatin (Zocor).
• Anticoagulants, or blood thinners. These may be administered to reduce your blood's potential to clot, particularly if you have previously had a blood clot. Anticoagulants include heparin, warfarin (Coumadin and Jantoven), dabigatran (Pradaxa), apixaban (Eliquis), and rivaroxaban (Xarelto).
• Immune-suppressing medicines. Immunomodulatory medications, such as corticosteroids, can reduce inflammation associated with some of the disorders that might cause nephrotic syndrome. Rituximab (Rituxan), cyclosporine, and cyclophosphamide are among the medications used.

Prevention

You cannot prevent nephrotic syndrome. However, you can alleviate the symptoms of nephrotic syndrome by treating the underlying cause and changing your diet.

Conclusion

Nephrotic syndrome is a significant kidney illness that requires timely diagnosis and treatment to avoid consequences. Understanding the reasons, recognizing the symptoms, and following treatment programs can help people manage the illness efficiently and retain a high quality of life. If you see any symptoms of nephrotic syndrome, you should seek medical assistance right away to ensure early intervention and the best possible outcomes. For information, visit SHALBY Sanar International Hospitals in Gurugram.