What is Nephrotic Syndrome
Nephrotic syndrome is a kidney disease in which a high amount of protein is filtered through the kidneys, resulting in low albumin and high lipid levels in the blood.
Kidneys cannot filter large proteins. In healthy kidneys, albumin protein, filtered by the glomerulus, is reabsorbed back into the blood at the proximal tubules. When kidneys are damaged, permeability for larger molecules increases, resulting in non-selective protein filtration.
The mechanism of action for developing nephrotic syndrome is unknown; however, it is believed that a type of white blood cell called t-lymphocytes may play a role in increasing membrane permeability to the anti-inflammatory response. Also, genetic defects in protein structure may contribute to congenital nephrotic syndrome.
Risk factors
v Medical conditions such as diabetes, lupus, amyloidosis, or damaged blood vessels in the glomerulus can contribute to nephrotic syndrome.
§ Diabetes is a major risk factor for chronic kidney disease, causing diabetes-related nephropathy caused by damage to the nerve systems of the kidneys.
§ Amyloidosis is a condition where plaque builds up in the body and most commonly affects the kidneys.
§ Focal segmental glomerulosclerosis is a condition that can create scarring of part of the glomeruli.
§ Autoimmune diseases such as lupus and membranous nephropathy, where the body’s immune system attacks the glomeruli of kidneys, causing inflammation and pain
v Infections such as hepatitis b and c, HIV, and malaria
v Certain classes of medications, such as over-the-counter (OTC) pain medications, blood pressure-lowering medications, antibiotics, or medications used to treat cancer, may contribute to nephrotic syndrome. Consult your pharmacist or doctor about the side effects of these medications.
Signs and symptoms
• Foam in urine (albuminuria)
• Swelling in legs, feet or ankles, hands, and face, around eyes and abdominal area
• Low blood albumin levels (hypoalbuminemia)
• High cholesterol (hyperlipidemia)
• Abdominal pain
• Loss of appetite
• Feeling tired or sick
• Weight gain due to edema
• Skin rash or sores
Complications arising from nephrotic syndrome can be of two types:
Nephrotic syndrome may lead to disease-related and treatment-related complications such as infections, clotting of veins in the kidney, abdominal pain, low blood pressure, high cholesterol, and inflammation of blood vessels. Anemia, acute and chronic kidney failure, and fluid retention
Drugs treating nephrotic syndrome may add to complications such as bone marrow suppression, infections, susceptibility to certain cancers, growth retardation in children, and gastrointestinal issues
References:
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Tapia, C. (2023, May 29). Nephrotic syndrome. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK470444/
Overview of nephrotic syndrome - genitourinary disorders. Merck manual professional edition. (n.d.). https://www.merckmanuals.com/professional/genitourinary-disorders/glomerular-disorders/overview-of-nephrotic-syndrome#etiology_v1055681
Mayo foundation for medical education and research. (n.d.-a). Nephrotic syndrome. Mayo clinic. https://www.mayoclinic.org/diseases-conditions/nephrotic-syndrome/symptoms-causes/syc-20375608
Nephrotic syndrome treatments, causes & symptoms. American Kidney Fund. (2023a, August 14). https://www.kidneyfund.org/all-about-kidneys/other-kidney-problems/nephrotic-syndrome-treatments-causes-symptoms
Mendoza SA. Nephrotoxic drugs. Pediatr nephrol. 1988 oct;2(4):466-76. Doi: 10.1007/bf00853443. Pmid: 3153061 https://www.ncbi.nlm.nih.gov/books/nbk553144/
Nephrotic syndrome. Mount Sinai health system. (n.d.). https://www.mountsinai.org/health-library/diseases-conditions/nephrotic-syndrome
Park, S. J., & SHIN, J. I. (2011). Complications of nephrotic syndrome. Korean journal of pediatrics, 54(8), 322–328. https://doi.org/10.3345/kjp.2011.54.8.322 Assessed and Endorsed by the MedReport Medical Review Board