What is Nephrotic Syndrome? Can children have it? Why does swelling occur?

Abnormal body swelling, especially around the eyes, legs, or abdomen, may be a warning sign of a kidney disease that many people are not familiar with, called Nephrotic Syndrome. If treatment is neglected, it may lead to serious complications. Then what is Nephrotic Syndrome? What are its causes? How is it treated? Is kidney inflammation with protein leakage dangerous?

Let us understand this type of kidney disease comprehensively, from initial symptoms, diagnostic methods, treatment, including self-care approaches when symptoms occur.

Key Takeaways

• Nephrotic Syndrome is a disease caused by abnormalities of the kidney units, resulting in protein leakage in the urine and swelling of the body

• Children can have Nephrotic Syndrome, and in some cases it can be cured if treated early

• Common initial symptoms are abnormal swelling, foamy urine, and may also include easy fatigue

• Treatment depends on the cause and symptoms, such as immunosuppressive drugs, diuretics, and dietary control

• If untreated, Nephrotic Syndrome may lead to serious complications such as kidney failure, blood clots, or infections due to low immunity

What is Nephrotic Syndrome?

Nephrotic Syndrome is a disease caused by abnormalities of the kidneys, so some people broadly refer to it as kidney disease, especially at the filtering unit of the kidney called the glomerulus, which functions to filter waste and control protein balance in the body. When this area becomes inflamed or damaged, essential proteins such as albumin leak out into the urine in greater amounts than normal

What are the causes of Nephrotic Syndrome?

Although Nephrotic Syndrome is a term used to describe a condition manifested by swelling and protein leakage in the urine, the underlying causes differ in each case. The causes can be classified into 2 types as follows

Primary nephrotic type

This group is caused by abnormalities directly in the kidney tissue, without other diseases as contributing causes. A common cause in primary Nephrotic Syndrome is Minimal Change Disease, which is commonly found in children, and also includes diseases with structural changes in kidney tissue such as Focal Segmental Glomerulosclerosis (FSGS) and Membranous Nephropathy

In addition, there are cases where some infants develop this condition from birth, which is related to genetics, and can be found even in families without a prior history of kidney disease

Secondary nephrotic type

Secondary nephrotic type is caused by factors or other diseases that affect kidney function, often found in adults or the elderly, such as

• Diabetes that is uncontrolled for a long time

• Autoimmune diseases such as SLE

• Chronic infections such as hepatitis B virus, malaria, or HIV

• Complications from certain cancers, especially in the blood system

• Side effects from medications or exposure to certain toxins

If found in children, it may come from different causes such as hypersensitive immune responses to vaccines or toxins from insects, but it is less common

What are the symptoms of Nephrotic Syndrome?

The initial symptom of Nephrotic Syndrome is swelling in the body, which can be observed as swelling around the eyes, especially in the morning after waking, swelling of the legs, the top of the feet, feet, or even abdominal swelling. In some cases, there may be swelling throughout the body. This swelling is not caused by injury or localized inflammation, but results from protein loss in the body due to protein leakage in the urine

Another common symptom is abnormally foamy urine, which is a sign of excessive albumin protein leaking into the urine, and may lead to other complications such as inability to urinate or reduced urine output

Complications that may occur from Nephrotic Syndrome if left untreated

Nephrotic Syndrome, if left untreated, can lead to various complications that may affect long-term quality of life as follows

• Increased susceptibility to infections. When the body loses protein through urine, the immune system becomes weakened, increasing the risk of infections such as peritonitis, pneumonia, or even bloodstream infections

• Formation of blood clots in the body. Loss of balance of certain proteins in the blood increases the chance of thrombosis, such as clots in the legs or lungs, which may be life-threatening if untreated

• Abnormally high blood lipids. When protein in the blood decreases, the body responds by trying to produce more protein and lipids, causing cholesterol and triglyceride levels to increase, which raises the risk of cardiovascular disease in the future

• Kidney deterioration or chronic kidney failure. If protein leakage persists without control, kidney function may gradually decline, eventually progressing to chronic kidney failure and requiring dialysis

• Chronic edema and malnutrition. Protein loss causes the body to retain more fluid, resulting in swelling, and may impair nutrient absorption, leading to deteriorating health

How is Nephrotic Syndrome diagnosed?

Diagnosis of Nephrotic Syndrome begins with physical examination and assessment of observable symptoms such as abnormal swelling together with foamy urine. Then the physician will perform a urine test to measure protein levels and a blood test to check albumin and blood lipids

When test results indicate possible kidney abnormality, the physician will consider history of related diseases such as diabetes, lupus, or certain infections to identify additional causes. Nephrotic Syndrome is a group of symptoms reflecting dysfunction of the kidney filtration units, so detailed investigations such as antibody testing or kidney biopsy may be required in some cases to confirm the cause and plan accurate treatment

How can Nephrotic Syndrome be treated?

Treatment of nephrotic syndrome varies in each case depending on whether the patient is a child or an adult, whether the cause is known, and the severity of symptoms. If symptoms are severe, albumin supplementation may be given, especially in children. If the cause is known, treatment will target that cause specifically, such as

• Treating the underlying cause directly, which may involve renal biopsy to obtain an accurate diagnosis before medication

• Antibiotics in cases of bacterial infection

• Antiviral drugs in cases of viral infection

• Blood sugar control medications in patients with diabetes

• Specific medications for autoimmune diseases such as SLE

• Albumin administration and use of diuretics in children with severe edema

• Treating associated symptoms and complications

• Diuretics such as furosemide to reduce swelling (considered individually)

• Antihypertensive drugs such as Enalapril, Losartan

• Lipid-lowering drugs such as Simvastatin

• Anticoagulants such as heparin or warfarin

• Use of immunosuppressive drugs

• Steroids such as prednisolone to control kidney inflammation

• In severe or resistant cases, other drugs may be used together such as Rituximab, Cyclosporine, Cyclophosphamide

• The physician will monitor results with regular blood and urine tests to adjust medication dosage appropriately

Nephrotic Syndrome is a condition caused by kidney abnormalities that should be treated promptly

Nephrotic Syndrome is a condition in which the kidneys function abnormally, causing protein to leak into the urine, resulting in body swelling, weakened immunity, and risk of other complications if not properly managed, especially in patients with underlying diseases such as diabetes or autoimmune disorders

If you notice swelling, foamy urine, or easy fatigue, you should promptly visit the Kidney Institute at Praram 9 Hospital to consult a physician, undergo screening, and receive proper treatment, because early management helps reduce risk and prevent kidney failure in the long term

For more information

Facebook : Praram 9 Hospital International & Expats

Line : @Praram9Hospital

Tel. 1270

Frequently asked questions about Nephrotic Syndrome

1. Can Nephrotic Syndrome be prevented?

Prevention of Nephrotic Syndrome involves general health care to reduce risk, such as controlling blood sugar, blood pressure, having annual health check-ups, and avoiding unnecessary use of medications that affect the kidneys

2. Can children have Nephrotic Syndrome?

Children can also have Nephrotic Syndrome. It often arises from causes different from adults, and in some cases can be completely cured when appropriately treated from an early stage

References

Cleveland Clinic. (n.d.). Nephrotic syndrome: Causes, symptoms & treatment. https://my.clevelandclinic.org/health/diseases/5989-nephrotic-syndrome

Kang, H., & Park, Y. (2023). Nephrotic syndrome. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470444/

National Health Service. (2023, June 14). Nephrotic syndrome in children. https://www.nhs.uk/conditions/nephrotic-syndrome/