Patient education: Nephrotic syndrome (The Basics)

What is nephrotic syndrome? — This is a group of problems suggesting that the kidneys are not working properly. It can be caused by different types of kidney disease.

People with nephrotic syndrome have:

●Very high levels of protein in their urine

●Low levels of a protein called "albumin" in their blood

●Swelling (also called "edema")

Normally, the kidneys filter blood and remove waste and excess salt and water. When the kidneys are healthy, proteins pass through them and stay in the blood, where they belong. If the kidneys are not working properly, some proteins can get into the urine instead. This leads to problems.

What causes nephrotic syndrome? — It can happen in children and adults. It can be caused by many different diseases that affect the kidneys. These include:

●Minimal change disease (more common in children)

●Focal segmental glomerulosclerosis

●Membranous nephropathy

●Diabetes

●Amyloidosis

●Lupus

What are the symptoms of nephrotic syndrome? — People usually have swelling. This often affects the area around the eyes and in the feet. It can also involve the ankles, legs, hands, arms, or belly. Because the body is holding on to too much salt and water, this can cause weight gain. It can also cause other symptoms. For example, if there is swelling in the digestive tract, this can lead to loss of appetite or vomiting.

Nephrotic syndrome also increases the risk of:

●Protein loss leading to less muscle

●High cholesterol

●Kidney failure

●Blood clots

●Infection

●Having too little water and salt in the blood

Will I need tests? — Yes. Your doctor or nurse will ask about your symptoms and do an exam. They will also order tests, such as:

●Urine tests – These check for protein in the urine. You might be asked to collect all of your urine over 24 hours. The urine is then measured and examined in a lab. In some cases, a single urine sample is tested instead.

●Blood tests – These can check the level of a protein called "albumin" in your blood. You might also need other blood tests, depending on your situation.

●Kidney biopsy – In adults, this is used to find the cause of nephrotic syndrome. A doctor will take a small sample of tissue from your kidney, then look at it under a microscope. This is not always done in children.

How is nephrotic syndrome treated? — Treatment involves managing the disease that caused nephrotic syndrome. For example, if you have diabetes or lupus, follow your treatment plan to help protect your kidneys. You might need to see a kidney specialist, called a "nephrologist."

Other treatment might include:

●Medicines to reduce protein in the urine

●Diuretics to help with swelling

●Following a low-salt diet

●Medicines to help lower cholesterol

●Medicines to prevent or treat blood clots

What can I do on my own? — You should:

●Take all of your medicines as instructed.

●Go to all your doctor's appointments. If your doctor recommends vaccines, it's important to get these to protect against infections.

●Ask your doctor if you need to track your weight or how much urine you make each day. You might need to bring this information with you to each visit.

●Be careful about what you eat, if you are on a low-salt diet. Check labels to know how much salt, or "sodium," is in different foods.

When should I call the doctor? — Call your doctor or nurse if:

●You have symptoms of an infection, such as a fever of 100.4°F (38°C) or higher.

●You are urinating less often than usual.

●Your swelling is getting worse.

More on this topic

Patient education: Albumin blood test (The Basics)
Patient education: Swelling (The Basics)
Patient education: Kidney disease caused by diabetes (The Basics)
Patient education: AL amyloidosis (The Basics)
Patient education: Lupus (The Basics)
Patient education: 24-hour urine collection (The Basics)
Patient education: Kidney biopsy (The Basics)
Patient education: Low-sodium diet (The Basics)

Patient education: The nephrotic syndrome (Beyond the Basics)
Patient education: Protein in the urine (proteinuria) (Beyond the Basics)
Patient education: Edema (swelling) (Beyond the Basics)
Patient education: Glomerular disease (Beyond the Basics)
Patient education: Systemic lupus erythematosus (Beyond the Basics)
Patient education: Collection of a 24-hour urine specimen (Beyond the Basics)
Patient education: Kidney (renal) biopsy (Beyond the Basics)
Patient education: Low-sodium diet (Beyond the Basics)