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by LaRusso L

Nephrotic Syndrome in Adults

Definition

Nephrotic syndrome is a set of symptoms and signs of kidney damage including:
  • Proteinuria—high amounts of protein in the urine
  • Hyperlipidemia—high fat and cholesterol levels in the blood
  • Edema—swelling in the blood
  • Hypoalbuminia—low levels of albumin (a protein made by the liver) in the blood
Anatomy of the Kidney
Glomerulonephritis
Copyright © Nucleus Medical Media, Inc.

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.
Diseases that may lead to nephrotic syndrome include:

Risk Factors

Factors that may increase your chance of nephrotic syndrome include:
  • Diabetes
  • Systemic lupus erythematosus
  • Exposure to drugs or toxins
  • Certain infections

Symptoms

Nephrotic syndrome may cause:
  • 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

You will be asked 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:
  • Blood tests
  • Urine tests
  • Biopsy
Imaging studies evaluate the kidney and surrounding 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 medications, 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.
  • Lower cholesterol and blood pressure with diet, exercise, and medications.

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

National Kidney Foundation
http://www.kidney.org
National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

CANADIAN RESOURCES

Health Canada
http://www.hc-sc.gc.ca
Kidney Foundation of Canada
http://www.kidney.ca

References

Nephrotic syndrome. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/nephrotic. Accessed June 1, 2016.
Nephrotic syndrome in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114446/Nephrotic-syndrome-in-adults. Updated March 21, 2016. Accessed June 1, 2016.
Nephrotic syndrome in adults. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/nephrotic-syndrome-in-adults/Pages/facts.aspx. Updated February 2014. Accessed July 12, 2013.

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