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

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    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:

        
  • 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

    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:

        
  • CT scan
  • MRI scan
  • Ultrasound
  • 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.