Nephrotic Syndrome

Nephrotic Syndrome

Nephrotic syndrome is a kidney disorder characterized by a group of signs and symptoms that occur due to increased glomerular permeability, leading to abnormal levels of protein in the urine, low levels of protein in the blood, and fluid retention (edema). It is not a disease itself but rather a set of symptoms that can be caused by various underlying kidney conditions.

The primary features of nephrotic syndrome include:

  1. Proteinuria: The hallmark of nephrotic syndrome is the excessive loss of protein in the urine. Normally, only a small amount of protein is excreted in the urine, but in nephrotic syndrome, large amounts of protein are lost, leading to hypoalbuminemia (low levels of albumin in the blood).

  2. Hypoalbuminemia: Due to the significant loss of protein in the urine, the blood levels of albumin (a major protein in the blood) decrease, resulting in hypoalbuminemia. This can lead to fluid accumulation and edema in various parts of the body, such as the ankles, feet, hands, and around the eyes.

  3. Edema: Fluid retention causes swelling, commonly in the legs, ankles, and feet. However, it can also occur in other areas of the body.

  4. Hyperlipidemia: The liver responds to the low levels of protein in the blood by producing more lipids (fats), which can lead to elevated cholesterol and triglyceride levels.

  5. Fatigue and Weakness: Low levels of albumin and the impact on bodily functions can lead to fatigue and weakness.

Nephrotic syndrome can be caused by various underlying kidney diseases, including:

  • Minimal Change Disease: A common cause in children and young adults, where kidney biopsy may show minimal changes under a microscope.
  • Focal Segmental Glomerulosclerosis (FSGS): Scar tissue forms in some glomeruli (the filtering units of the kidneys).
  • Membranous Nephropathy: Thickening of the glomerular basement membrane.
  • Membranoproliferative Glomerulonephritis (MPGN): Inflammation and changes in the glomeruli.
  • Diabetic Nephropathy: Kidney damage due to diabetes.
  • Systemic Lupus Erythematosus (SLE): An autoimmune disease that can affect multiple organs, including the kidneys.

Diagnosis of nephrotic syndrome involves a combination of clinical evaluation, blood tests to assess protein and lipid levels, urine tests to measure protein excretion, and sometimes a kidney biopsy to determine the underlying cause.

Treatment aims to address the underlying cause, control symptoms, and prevent complications. It may include medications to reduce proteinuria, manage blood pressure, and control edema. In some cases, immunosuppressive drugs may be used, especially if the cause is an autoimmune condition.

Regular follow-up with a nephrologist (kidney specialist) is essential for the management of nephrotic syndrome and to monitor kidney function and response to treatment.

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