Nephrotic Syndrome, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

Nephrotic Syndrome is a rare medical disorder characterized by the edema (accumulation of fluid in the body, hypoalbumemia (low protein) and proteinuria (protein loss through the kidneys).

What is the cause of Nephrotic Syndrome?

The cause is the higher capillary permeability of the glomeruli to plasma protein due to the inflammation that permits the retention of salt, water and nitrogen and loss of blood and protein in urine.

Loss of negative charges on the filtering membrane permits negatively charged molecules including albumin to enter the urinary tract.

Reduced protein in the blood leads to edema.

Nephrotic syndrome is caused by different disorders that damage the kidneys.

This damage results in the escape of too much protein in the urine.

The most frequent cause in children is minimal change disease.

Membranous glomerulonephritis is the most frequent cause in adults.

This condition can also occur from:

1. Diseases such as diabetes, multiple myeloma, amyloidosis, and systemic lupus erythematosus,
2. Genetic disorders
3. Immune disorders
4. Infections (such as strep throat, hepatitis, or mononucleosis)
5. Use of certain drugs
6. Cancer

It can occur with kidney disorders such as:
1. Focal and segmental glomerulosclerosis
2. Glomerulonephritis
3. Mesangiocapillary glomerulonephritis
4. Nephrotic syndrome can involve all age groups.

In children, it is most frequent between ages 2 and 6.

This disorder occurs slightly more often in males than females.

What are the types of Nephrotic Syndrome?

There are 3 types of Nephrotic Syndrome:

1. Minimal Change Nephropathy (MCN) happens in children with very little microscopic changes in the glomerular tissues of the kidney.

2. Focal glomerulonephritis appears similar to MCN above but develop sclerosis of the glomeruli eventually.

3. Diffuse proliferative glomerulonephritis and membranous nephropathy are more frequent in adults and be secondary to other diseases such as:
a. Diabetes
b. SLE and other connective tissues
c. Allergies to drugs such as penicillamine, probenecid, tolbutamide
d. Particular infections
e. Cancer (carcinomas and lymphomas)

Symptoms:

1. Urine may show the loss of protein at least 3.0g/day

2. Low protein in blood causes reduced plasma mass pressure leading to retention of water and salts

3. Swelling of the face and ankle occurs as a result

4. Edema occurs from puffiness of eyes, ascites (water in abdominal cavity), pleural effusions (water in the lungs) to generalized edema

5. With rising edema and nitrogen retention, headaches, nausea and vomiting may occur.

6. High blood pressure may occur in one third of patients

7. The blood in nephrotic syndrome tends to clot easily and the patient may develop blood clots in his leg veins.

8. Lipids may be raised in the blood especially triglycerides and cholesterol

9. Symptoms and signs of underlying diseases such as diabetes, SLE etc may be present

Swelling (edema) is the most common symptom.

TABLE OF CONTENT
Introduction

Chapter 1 Nephrotic Syndrome

Chapter 2 Causes

Chapter 3 Symptoms

Chapter 4 Diagnosis

Chapter 5 Treatment

Chapter 6 Prognosis

Chapter 7 Glomerulonephritis

Chapter 8 Polycystic Kidneys

Epilogue