A chronic kidney disease which is characterized by swelling (oedema) and fluid retention, presence of excess amounts of protein in the urine, hypoalbuminemia (high serum levels of albumin) and high cholesterol level, is known as Nephrotic Syndrome. It is non-specific disorder where kidneys are damaged, which causes them to leak protein in very large amount. Kidneys that are affected by nephrotic syndrome have small pores present in the podocytes (cells in the Bowman’s capsule), which are enough large to allow protein to pass through urine, subsequently causing hyoalbuminemia, as few protein albumin passes from blood to the urine. The pores are not large enough to permit cells to pass through them, hence there is no hematuria.
Minimal Change Disease is the most general cause of nephrotic syndrome in children. It is a disorder of the kidneys, where the nephrons of the kidney, which does not have a regular and normal view under regular microscope, can be viewed normally and regularly under microscope.
In adults Membranous Glomerulonephritis is the most general cause of nephritic syndrome. Membranous Glomerulenephritis or Membranous Nephropathy is a disorder of the kidney which leads to the inflammation and changes in the structure inside the kidney, which helps in the filtration of fluids and wastes. Problems with the functioning of the kidney may be caused due to the inflammation.
Nephrotic Syndrome may also occur due to the following:
- Diseases like:
a) Systematic lupus erythematosus: It is an autoimmune disorder which can affect kidneys, brain, skin, joints and other organs.
b) Multiple Myeloma: It is a type of cancer which occurs in the bone marrow (soft and spongy tissue that is found in the bone, which helps in making blood cells).
c) Amyloidosis: It is a disorder in which abnormal quantity of protein is build up in the organs and tissues.
d) Diabetes: It is a lifelong disease in which high level of blood sugar is found in the blood.
- Immune disorders.
- Genetic disorders.
- Infections like:
a) Strep throat.
c) Mononucleosis: It is a viral infection that causes swollen glands, sore throat and fever.
Nephrotic syndrome may also occur due to some kidney disorders like:
- Focal segmental glomerulosclerosis: It is a form of scar tissues that are produced in the parts of the kidney known as glomureli. The glomureli works as a filter, which help the body in getting rid of harmful and unnecessary products. Thousands of glomureli are present in each kidney.
- Glomerulonephritis: It is a kidney disease in which the part that helps in filtering fluids and wastes, in the kidney, gets damaged.
- Mesangiocapillary glomerulonephritis.
SYMPTOMS: nephritic syndrome may show some of the common symptoms like:
- Swelling: It is the most general symptom of nephritic syndrome. Swelling may be observed in the following places:
a) Facial swelling (swelling around the eyes and in the face).
b) Swelling in the legs (commonly in the ankles and feet) and arms.
c) Swollen abdomen (swelling in the belly area).
- Appearance of foam in the urine.
- Reduced desire to eat (poor appetite).
- Unintentional weight gain.
CONSEQUENCES IF NOT TREATED: Nephrotic Syndrome if left untreated may cause the following:
- Blood Clots: Incapability of the glomeruli of filtering the blood may lead to loss of proteins that help prevent clotting. This may develop the risk of blood development in the veins.
- Poor nutrition: When too much of protein is lost, it may lead to malnutrition.
- Chronic Kidney failure: Kidneys may slowly lose their function due to nephritic syndrome. It may lead to the requirement of a kidney transplant or dialysis.
- Hypertension: Damage of glomeruli resulting in the building up of wastes in the bloodstream may cause hypertension.
- Infection: People having nephritic syndrome are more exposed to the risk of getting infections.
RECOMMENDATION: People having nephritic syndrome should follow the following recommendations:
- Blood pressure should be kept below or at 130/80 mmHg.
- Intake of corticosteroids and other drugs may be advisable to suppress the immune system.
- Should follow a low protein diet.
- If nephritic syndrome is chronic and does not respond to treatment, intake of vitamin D may be required.
- To prevent or treat blood clots, blood thinners may be required.