Idiopathic nephrotic syndrome

Nephrotic syndrome is the name of a set of symptoms that occur as a result of damage to the filtering units in the kidneys. The syndrome often results in swelling of the feet, hands, and face and foamy urine. Different conditions can lead to nephrotic syndrome, and treatment of the corresponding symptoms depends on the underlying cause. If no definitive cause for the kidney damage can be identified, then it is referred to as "idiopathic." This is often the case in children.

The filtering units in the kidneys are called glomeruli. These filter waste products and excess water from the blood and normally prevent protein from escaping from the blood into the urine. When these filters are damaged, too much protein escapes from the blood into the urine. In turn, fluid accumulates in the body and causes swelling. There are several conditions that can damage the glomeruli and cause the symptoms of nephrotic syndrome. It is only called idiopathic once all of the possible underlying conditions can be ruled out and no other cause is found.

Possible symptoms include swelling of the feet, ankles, or eyelids, weight gain (due to fluid accumulation), foamy urine, loss of appetite, and fatigue. When a large amount of fluid accumulates in the body, it can eventually build up in the abdomen and chest, leading to a large, tight abdomen and shortness of breath.

Diagnosis is made by a physician and depends on protein levels in the blood and urine. Blood tests are also performed to check kidney and liver function and to look for inflammation. An ultrasound examination may be needed. Sometimes a small tissue sample of the kidney (biopsy) must be taken to look for underlying causes of kidney damage.

It is important to diagnose and treat any underlying condition. If no underlying condition can be found, only the symptoms can be treated. Medications used to control symptoms often include anti-inflammatory steroids. In some cases, diuretics (also known as water tablets, to reduce fluid buildup in the body), blood pressure medication (to protect the kidneys from further damage), and anti-inflammatory medications (to reduce any inflammation that could lead to kidney damage) are also used. It is recommended that the intake of salt and fluids be reduced.

Recovery from nephrotic syndrome is good in many cases, with no further problems. However, it depends on the underlying cause, the age of the affected person, and how they respond to treatment. In severe cases, kidney failure may occur. This case requires dialysis to replace kidney function and eventually a kidney transplant.