Nephrotic syndrome Facts for Kids

Swelling of face in a child with nephrotic syndrome

Nephrotic syndrome is a health problem that causes a group of signs and symptoms. It happens when your kidneys get damaged. This is different from something called nephritic syndrome, where you might see red blood cells in your pee, making it look reddish.

Doctors find Nephrotic syndrome by looking for a few main signs. These include swelling (oedema), protein in your pee (proteinuria), low levels of a protein called albumin in your blood (hypoalbuminemia), and high levels of fats in your blood (hyperlipidaemia).

What are the signs of Nephrotic Syndrome?
What causes Nephrotic Syndrome?
- Primary causes
- Secondary causes
How is Nephrotic Syndrome treated?
What is the outlook for Nephrotic Syndrome?
Images for kids
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What are the signs of Nephrotic Syndrome?

Oedema: This is swelling in your body. It often shows up in your face, especially around your eyes, and in your legs and feet.
Proteinuria: This means there is too much protein in your pee. Your kidneys normally stop protein from leaving your body.
Hypoalbuminemia: This is when you have low levels of a protein called albumin in your blood. Albumin helps keep fluid in your blood vessels.
Hyperlipidaemia: This means you have high levels of fats (lipids) in your blood.
Lipiduria: Sometimes, fats can also pass into your pee.
Hyponatremia: This is when you have low levels of sodium (salt) in your blood.
Frothy urine: Your pee might look foamy or frothy because of the extra protein in it.

What causes Nephrotic Syndrome?

The causes of Nephrotic syndrome can be grouped into two main types: primary and secondary.

Primary causes

Primary causes are problems that start directly within the kidneys.

Minimal change disease (MCD): This is the most common cause in children. The kidney looks almost normal under a microscope, but it is not working right.
Focal segmental glomerulosclerosis (FSGS): This is another kidney disease where some parts of the kidney's filtering units (called glomeruli) become scarred.

Secondary causes

Secondary causes are health conditions that affect other parts of the body, but they can also harm the kidneys.

Diabetes: This is a condition where your body has trouble controlling blood sugar levels. High blood sugar can damage the kidneys over time.
Systemic lupus erythematosus (SLE): This is an autoimmune disease. It means your body's immune system accidentally attacks its own healthy tissues, including the kidneys.
Vasculitis: This is when your blood vessels become inflamed or swollen. This inflammation can damage the tiny blood vessels in your kidneys.

How is Nephrotic Syndrome treated?

Treatment for Nephrotic syndrome usually involves medicines that help reduce the damage to your kidneys.

Doctors often use drugs like Prednisone, Cyclophosphamide, and levamisole. These medicines help calm down the immune system and reduce inflammation.
If you have low albumin levels, doctors might give you albumin through a vein (an IV drip). This helps bring your albumin levels back up.
To get rid of extra fluid that causes swelling, doctors use medicines called "diuretics" (often called water pills). These help your body remove extra water through pee.
People with Nephrotic syndrome are often advised to eat less salt and fat. They also need to be careful about how much fluid they drink.

What is the outlook for Nephrotic Syndrome?

Prognosis is a medical term that means the likely outcome or future of a disease. A "good prognosis" means the person is expected to get better without lasting problems.

For children, Nephrotic syndrome usually has a good prognosis. This means most children recover well and do not have permanent kidney damage.

However, for children younger than 5 years old and adults over 30 years old, the prognosis is often not as good. In these groups, the disease might come back after some time. They might need to take medicine for a longer time to keep the condition under control and prevent lasting kidney damage.

Images for kids

Histological image of a normal kidney glomerulus. It is possible to see a glomerulus in the centre of the image surrounded by kidney tubules.
Diabetic glomerulonephritis in a person with nephrotic syndrome.
Ultrasound of a kidney with nephrotic syndrome. There is a hyperechoic kidney without demarcation of the cortex and medulla.