Know All About
Nephrotic Syndrome
Definition:
One of the two common kidney diseases afflicting the children (other being acute glomerulonephritis). Nephrotic syndrome is characterized by high content of protein in urine, swelling of the skin and organs, and low protein and high cholesterol in the blood.
It is a clinical condition characterized by massive loss of proteins in the urine causing hypoproteinemia (low protein) resulting in oedema.
Sex or Age most Affected
Children between 2-6 yrs. It affects more boys than girls.
Signs & Symptons
- Retention of water that appears first as swollen eyes and ankles, then as general swelling of the skin, and eventually as a swollen abdomen.
- Reduced urine production, sometimes as low as 20% of normal.
- Loss of appetite; weakness; general ill feeling.
Causes
Exact cause is not known. It may be primary (of unknown cause) or may occur as a complication of other problems, which affect kidney function, glomerulonephritis; severe allergic disorders; infections- especially of the skin; congenital heart disease; or some medications.
Children more at risk:
Family history of nephrotic syndrome (primary form only).
Prevention
Obtain prompt medical treatment for skin and throat infections
Diagnostic Measures
- Telltale symptoms.
- History and physical exam by a doctor.
- Laboratory studies, such as urinalysis and blood studies of protein and cholesterol.
- Kidney biopsy (not in all).
Possible Complications
- Kidney disease that resembles chronic glomerulonephritis.
- Kidney failure.
- Increased susceptibility to infections.
Probable Outcomes
Nephrotic syndrome can’t be cured or prevented. However, medication and diet can control swelling and reverse kidney abnormalities in many children.
Although symptoms usually disappear in 2 weeks with treatment, medication is continued for 6 to 8 weeks. Relapses are common and the treatment must be repeated in case of a relapse. If kidney failure develops, dialysis or a kidney transplant can prolong life.
TREATMENT
General Measures
During the acute phase:
- Keep a record of your child’s temperature each morning and evening.
- Maintain Intake/ Output chart i.e. Collect all urine passed during each 24 hours and record the amount. Also record all fluids consumed. Portions of the urine will be analyzed by your doctor for protein content.
Medication
Your doctor may prescribe:
- Steroids or immunosuppressive drugs to reduce kidney inflammation.
- Diuretics, including potassium-saving diuretics, to reduce fluid retention.
- Antibiotics to control infection.
Activity
Stay in bed (except for trips to the bathroom) until the edema (water retention) improves. After the swelling decreases, be as mildly active as your strength allows.
Diet
Serve food without salt. Avoid prepared foods that contain extra salt like pickles, chutneys and papad. Include more protein than usual, such as soyabean, sprouts, fish, meat, eggs etc.
Ask your doctor regarding need to restrict fluid intake.
Contact your Doctor
- You notice your child having swelling below eyelids.
The following occurs during treatment:
- Severe headache.
- Convulsion.
- Extreme weakness.
- Signs of infection, such as fever, sores on the skin, cough or burning on urination.
- Failure to pass even 200 ml of urine in a 24-hour period.
- Increased swelling.
- Vomiting, diarrhea or nausea.