Nephrotic syndrome

Alternative names

Nephrosis

Definition

Nephrotic syndrome is a constellation of signs and symptoms including protein in the urine (exceeding 3.5 grams per day), low blood protein levels, High Cholesterol levels, and swelling. The urine may also contain fat, which is visible under the microscope.

Causes, incidence, and risk factors

Nephrotic syndrome is caused by various disorders that damage the kidneys, particularly the basement membrane of the glomerulus. This immediately causes abnormal excretion of protein in the urine.

The most common cause in children is minimal change disease, while membranous glomerulonephritis is the most common cause in adults.

This condition can also occur as a result of infection, drug exposure, malignancy, hereditary disorders, immune disorders, or diseases that affect multiple body systems including Diabetes, Systemic lupus erythematosus, Multiple Myeloma, and amyloidosis. It can accompany kidney disorders, including glomerulonephritis, focal and segmental glomerulosclerosis, and mesangiocapillary glomerulonephritis.

Nephrotic syndrome can affect all age groups. In children, it is most common from age 2 to 6. Males are slightly more likely to be affected than females.

Symptoms

• Swelling (edema)
  o general
  o around the eyes
  o in the extremities, especially the feet and ankles
  
• Swollen abdomen
  
• Facial swelling
  
• Foamy appearance of the urine
  
• Weight gain (unintentional) from fluid retention
  
• Poor appetite
  
• High blood pressure
  

Signs and tests
Physical examination can detect some symptoms. Other symptoms and signs of causative disorders can also be found with examination.

Urinalysis reveals large amounts of urine protein. Fats are often also present in the urine.

Tests to rule out various causes may include the following:

• Glucose tolerance test
  
• Antinuclear antibody