Every year, around 200,000 people in the United States suffer from nephrotic syndrome. This is a disorder affecting the kidneys, causing them to leak protein into the urine. Nephrotic syndrome is actually a group of symptoms and findings that include:
- High levels of protein in the urine
- Low levels of protein in the blood
- Swelling due to abnormal buildup of fluid in tissue
Our kidneys help remove waste and excess fluid from the blood. They do this by passing blood through a filter called a nephron. At the beginning of each nephron is a network of blood vessels called a glomerulus. Each nephron screens our blood and removes the waste products and excess water by filtering it through the glomerulus. Nephrotic syndrome damages these nephrons and glomeruli and allows too much protein to slip through into the urine. This leads to swelling and increases the chances you develop further health problems. There are risk factors and warning signs you should be aware of - PatientsLikeMe has the breakdown.
Causes of Nephrotic Syndrome
Nephrotic syndrome can come about from diseases that affect only the kidneys or from diseases that affect many parts of the body. Here are a few possible causes to watch out for.
- Diabetic Kidney Disease: Diabetes can damage the kidneys. Sometimes this damage can be to the nephrons, leading to nephrotic syndrome.
- Focal Segmental Glomerulosclerosis (FSGS): FSGS is when scar tissue builds up on the glomeruli, part of the nephron. This can be caused by a genetic defect or certain medications, as well as other diseases like diabetes or sickle cell.
- Membranous Nephropathy: This autoimmune disease is when your immune system attacks your glomeruli, causing them to thicken. This damage causes you to lose large amounts of protein into your urine.
- Minimal Change Disease: This condition is most common in children. Here, damage is done to the glomeruli that is not visible under a regular microscope, hence the name. It can be caused by infection, tumors, certain medications, and allergic reactions.
- Amyloidosis: Amyloidosis is the accumulation of amyloid proteins in different organs. These proteins are misfolded, and cause damage wherever they buildup. If they land in the kidney, they can impact its ability to filter your blood.
- Lupus: Systemic lupus erythematosus is a chronic condition that causes inflammation. This inflammation can lead to serious kidney damage over time.
Common Symptoms of Nephrotic Syndrome
- Severe swelling, particularly around your ankles, feet and eyes
- Foamy urine
- Weight gain
- Fatigue
- Loss of appetite
How Nephrotic Syndrome Affects the Body
Nephrotic syndrome can cause a few complications if left untreated. Proteins in your blood actually help prevent clotting. If these proteins are lost through the urine, you are at a higher risk of developing a blood clot. At the same time, when protein levels in the blood fall your body compensates by producing more albumin, a protein made by the liver. Unfortunately this is accompanied by cholesterol and triglycerides. Excess fluid buildup can also raise your blood pressure.
Malnutrition is another potential risk. Loosing blood protein can lead to weight loss or anemia, as well as low levels of vitamin D. Over time, the risk of acute kidney injury increases. Waste products buildup in your blood because your kidney has lost its ability to filter properly. This could require dialysis to treat. Chronic kidney disease is another potential risk as the kidneys lose their ability to function. People with nephrotic syndrome are also at a higher risk of infection.
Diagnosis and Treatment
Doctors can diagnose nephrotic syndrome with urine and blood tests. Urine tests can check for high levels of protein. Blood tests on the other hand look for low levels of protein and high levels of both cholesterol and fats. Sometimes, a kidney biopsy may be needed. This involves taking a small sample of kidney tissue to look at under a microscope.
Treatment focuses on managing symptoms and the underlying cause. If the cause is diabetes, or lupus, or FSGS, then doctors will focus their efforts on treating that condition while managing the symptoms of nephrotic syndrome. Almost all patients are given ACE inhibitors or an angiotensin receptor blocker (ARB). These help lower blood pressure, prevent the kidney disease from progressing, and reduce the amount of protein in the blood. The following steps can be taken for each symptom:
- Swelling: A low-sodium diet and diuretics (water pills) can help manage this symptom.
- High Cholesterol: The most common method for managing high cholesterol is with a medication known as a statin.
- Blood Clots: A blood thinner such as warfarin will help manage clots should they occur.
Living with nephrotic syndrome means regular check-ups and working with your doctor on medication and lifestyle changes. With proper treatment, you can lead a healthy life! If you notice symptoms like swelling, foamy urine, or feeling unusually tired, it's important to see a doctor. Early diagnosis and treatment can help manage the condition and prevent complications.